人工韧带联合自体肌腱在前交叉韧带重建失败后翻修手术中应用

目的探讨在前交叉韧带重建失败后,应用LARS新型中空人工韧带联合自体肌腱行翻修手术的可行性及短期临床效果。方法回顾性分析自2015年6月至2016年7月收治的因前交叉韧带重建失败行翻修手术的11例患者的临床资料。11例患者均在关节镜下行翻修手术,采用LARS新型中空人工韧带联合自体肌腱重建前交叉韧带,采用KT-2000检查术前与末次随访时膝关节屈曲30°平均差值,根据国际膝关节评分委员会评分标准(IKDC)、Lysholm及Tegner评分系统对术前及末次随访时患者情况进行评价,探讨其临床疗效。结果本组患者随访6~18个月,平均12个月。末次随访时,膝关节屈曲30°平均差值较术前明显减小[(2.05±0.28)mm比(6.15±0.85)mm],差异有统计学意义(P<0.01)。末次随访时,IKDC、Tegner及Lysholm评分均较翻修前有显著改善,差异有统计学意义(P<0.01)。结论 LARS中空人工韧带联合自体肌腱在前交叉韧带重建失败翻修术中是一种可行的移植物选择,术后临床效果改善明显,值得推广。

Artificial ligament combined with autologous tendon in revision surgery after the failure of ACL reconstruction

Objective To investigate the practicability and short term effective of artificial ligament(LARS) combined with autologous tendon used in revision surgery after anterior cmciate ligament (ACL) reconstruction failure.Methods A retrospective study was performed on 11 patients who received a revision surgery after failure of ACL reconstruction from June 2015 to July 2016.All of the 11 patients applied artificial ligament combined with autologous tendon in revision surgery by arthroscopic technique.The preoperative and the last follow-up of IKDC,KT-2000,Lysholm and Tegner score were analyzed to evaluate the clinical result.Results The average follow-up time was 12 (6-18)months.The last follow-up,knee flexion at 30°,the average difference significantly reduced comparing with that before the operation [(2.05 ± 0.28) mm versus (6.15 ± 0.85) mm],and the difference was statistically significant (P ＜ 0.01).The last followup,IKDC,Tegner and Lysholm score were improved significantly comparing those before the operation,and the difference was statistically significant(P ＜ 0.01).Conclusion Artificial ligament combined with autologous tendon is a kind of effective graft in revision surgery after failure of ACL reconstruction.The postoperative clinical result improves significantly and it is worthy of popularizing.