关节镜下采用6～8股腘绳肌腱单束重建前交叉韧带

目的:探讨关节镜下采用6-8股腘绳肌肌腱单束重建前交叉韧带对恢复膝关节稳定性的临床效果。方法:前交叉韧带损伤患者14例,男9例,女5例;年龄19-51岁,平均32.8岁;病程1-22个月,平均3.7个月。Lachman试验:阳性伴软性终止点12例,阳性伴硬性终止点2例;前抽屉试验:阳性伴软性终止点12例,阳性伴硬性终止点2例;轴移试验阳性12例。合并I度膝关节外翻不稳1例。在关节镜下采用6-8股腘绳肌肌腱单束重建,4孔指骨钢板对移植物行悬吊式固定。结果:术后1年随访,13例患者Lachman试验阴性,1例患者Lachman试验阳性,13例患者轴移试验阴性,1例患者阳性。按照Lysholm膝关节评分标准,评分从术前平均(47.71±1.98)分提高至术后平均(95.36±4.73)分,差异有显著性意义(P<0.01)。结论:关节镜下采用6-8股腘绳肌肌腱单束重建前交叉韧带是恢复膝关节稳定性的可靠方法,具有切口小,对伸膝装置无干扰等优点。

Arthroscopic reconstruction of anterior cruciate ligament with over six strands of hamstring tendons

Objective:To study the effect of arthroscopic reconstruction of anterior cruciate ligament with over six strands of hamstring tendons.Methods:Fourteen patients with anterior cruciate ligament injury included 9 male and 5 female with the average age of 32.8 years ranging from 19 to 51 years.The course was from 1 to 22 months(mean 3.7 months).Twelve patients had positive Lachman test with mollis termination,and 2 patients had positive Lachman test with hardness termination.Anterior drawer test with mollis termination was positive in 12 cases,and anterior drawer test with hardness termination was positive in 2 cases.Pivot shift test was positive in 12 cases,and Valgus test was one degree positive in 1 case.Fourteen cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with over six strands of hamstring tendons in way of one-bundle.The grafts were fixed with suspension technique by mini-plates.The patients were followed up for one year.Results:Thirteen patients had negative Lachman test,and one patient showed positive Lachman test.Pivot shift test was negative in 13 cases,and was positive in one case.The clinical results were evaluated according to Lysholm rating scale.The Lysholm score increases from(47.71±1.98) to(95.38±4.73)(P<0.01).Conclusion:Arthroscopic reconstruction of anterior cruciate ligament with over six strands of hamstring tendons is reliable to restore the stability of the knee.