采用异体腘绳肌腱Rigidfix交叉钉与Intrafix膨胀挤压螺钉重建前交叉韧带初步报道

前交叉韧带(anterior cruciate ligament,ACL)损伤是常见的膝关节韧带损伤,如不及时修复将造成膝关节其他韧带松弛、关节软骨退变、半月板损伤等并发症,严重影响膝关节功能。关节镜下ACL重建术作为修复ACL、延缓膝关节退变的重要方法1],已被广泛应用于临床,其移植物和移植材料

ANTERIOR CRUCIAL LIGAMENT RECONSTRUCTION WITH ALLOGRAFT HAMSTRING FIXED BY RIGIDFIX AND INTRAFIX ANCHORAGES

OBJECTIVE: To explore an improved reconstruction of the anterior crucial ligament (ACL) with the allograft hamstring fixed by the Rigidfix and Intrafix anchorages and to evaluate its therapeutic effectiveness in a short term. METHODS: The ACL reconstruction was performed under the arthroscope on 21 patients' knees from Janaury 2006 to December 2006. There were 13 males and 8 females aged from 18 to 53 years. The injuries were caused by a traffic accident in 7 patients, a movement damage in 11, and other factors in 3. The medial collateral ligament(MCL) and the medial meniscus were injured in 10 patients, the medial meniscus and the lateral meniscus were injured in 3, the lateral meniscus was injured in 6, and only the ACL was injured in 2. The operations were performed 7 days to 3 months after the injuries. The graft used was the four-stranded allograft hamstring, which was fixed by the Rigidfix and Intrafix anchorages. The therapeutic effect was evaluated according to the Lysholm rating scale. RESULTS: The follow-up of all the 21 patients for 3-9 months (average, 5.8 months) revealed that the knees of 19 patients could move beyond 120 degrees after operation. In 1 patient who had the MCL injury, the range of genuflex was limited to 80 degrees at 3 months after operation, and so the operation of lysis was performed under the arthroscope again. In 1 patient, the rejection against the allograft was treated by the irrigating under the arthroscope but had little effect. The anterior drawer test and the pivot shift test were negative in the 21 patients. During the Lanchman test, 1 patient had a positive result (Degree I ). The Lysholm scores were significantly increased from 56.73 +/- 6.58 to 88.14 +/- 7.02 (P < 0.01). CONCLUSION: The surgical approach to reconstruction of ACL with the four-stranded allograft hamstring fixed by the Rigidfix and Intrafix anchorages is feasible and safe. The resulting fixation is reliable. The patients can begin their postoperative rehabilitation exercise earlier and their movement function can be restored earlier.