单隧道四股半腱肌股薄肌肌腱重建前交叉韧带后的康复训练

【目的】探讨采用单隧道四股半腱肌股薄肌肌腱重建前交叉韧带后的康复训练方法，总结其近期康复效果。【方法】对49例前交叉韧带断裂的患者采用单隧道四股半腱肌股薄肌肌腱进行重建，术后进行1年以上系统的康复指导。包括支具制动及肌力、活动度、本体感受器训练和肌肉牵张训练等。观察其可行性和效果。【结果】术后3个月，患者膝关节的活动度均恢复正常。术后12个月，患肢的股四头肌和胭绳肌峰力矩比值超过正常侧的82％。术后6个月，膝关节Lanchman试验和轴移试验均为阴性。术后6个月，膝关节功能评分为与术前相比差异有显著性（P〈0．01）。【结论】对于前交叉韧带损伤患者，在采用单隧道四股半腱肌股薄肌肌腱进行重建后进行此康复训练是安全有效的。

Rehabilitation Training after Arthroscopic Reconstruction of ACL with Quadruple-Stranded Semitendinosus Tendon/gracilis Tendon in Single Tunnel

Objective] To observe the rehabilitation methods after arthroscopic reconstruction of anterior cruciate ligament（ACL） with quadruple-stranded semitendinosus tendon/gracilis tendon in single tunnel, and to evaluate the short-term outcome. Methods] Forty nine cases with disrupted ACL underwent quadruplestranded semitendinosus tendon/graeilis tendon in single tunnel. After operation, they were instructed rehabilitation for more than one year. The rehabilitation program included brace immobilization and exercises for muscle strength, range of motion, proprioception and muscle extension. The feasibility and effect were observed. Results] The range of motion of the operated knee were regained 3 months after surgery. The quadriceps/ hamstrings peak ratio reached 82% of the uninjured leg 12 months after operation. The Lanchman test and pivot shift test of knee joint were negative 6 months after operation. There was significant difference in the knee joint scores between 6 months after operation and before operation（ P 〈0.01）. Conclusion] For the patients with ACL injury, the rehabilitation training after reconstruction of ACL with quadruple-stranded semitendinosus tendon/graeilis tendon in single tunnel is safe and effective.