关节镜下半腱肌/股薄肌腱移植重建前交叉韧带

目的 探讨膝关节镜下采用自体半腱肌／股薄肌腱移植重建前交叉韧带的方法和效果。方法 回顾分析54例膝关节镜下应用自体双股半腱肌／股薄肌腱移植重建前交叉韧带的情况，随访2年以上纳入分析。采用Lysholm关节评分、国际膝关节文献编制委员会0KDC）分级评估标准和KT-1000关节测量仪测定稳定性评价疗效。结果 平均随访30．8个月，Lysholm关节评分由术前58分提高到术后95分，优良率96．3％。IKDC功能评价29例（53．7％）正常、24例（44.5％）基本正常、1例（1．8％）异常。KT-1000测定优38例（70．4％），良15例（27．8%），差1例（1．8%），平均移动度2．1mm。结论 关节镜下自体双股半腱肌／股薄肌腱移植重建前交叉韧带方法可行，疗效确切。术后能早期康复锻炼，稳定性好，并发症少。

Arthroscopic reconstruction of anterior crucial ligament using semitendinosus-cracilis autograft

Objective] To investigate the surgical technique of arthroscopic isometric anterior crucial ligament reconstruction using hamstring tendon autograft and evaluate its efficacy. Methods] A retrospective analysis was done in 54 consecutive patients with a chronic ruptured anterior crucial ligament underwent arthroscopic reconstruction using an ipsilateral semitendinosus-gracilis autograft. Concurrent operative procedures were performed during the arthroscopic procedure included repair of a meniscal tear. The mean age of patients was 33.1 year old, with a minimum follow-up of 24 months. The patient satisfaction was assessed with the Lysholm knee score pre- and postoperatively and functional status was assessed with the International Knee Documentation Committee (IKDC) rating scale. A KT-1000 arthrometer was used for evaluating ACL ligament stability. Results] Average follow-up was 30.8 months (range, 24 to 48 months). The median Lysholm knee score was improved from 58 preoperatively to 95 postoperatively. Overall, 96.3% of patients had a good or excellent result. According to overall IKDC assessment, 29(53.7%), 24(44.5%) and 1(1.8%) cases had been graded A, B and C respectively. Average KT-1000 side-to-side laxity measurement was 2.1 mm. At 24 months after operation, all patients had excellent knee stability, a high rate of return to sport or work and minimal radiological evidence of degenerative change. No complication of disrupt graft was found. Conclusion] Arthroscopic anterior crucial ligament reconstruction using two-strand semitendinosus- gracilis autograft is a reasonable alterative to ACL reconstruction that has a high short- term stability rate, high patient satisfaction level, good postoperative function and a low postoperative complication rate. Early and systemic postoperative exercises are the key for successful rehabilitation.