经前内侧入路单束4股腘绳肌腱移植重建前交叉韧带

背景:国内外对于经膝关节前内侧入路建立前交叉韧带股骨隧道的临床文献尚缺乏。目的:探讨经膝关节前内侧入路单束4股腘绳肌腱重建前交叉韧带的可行性。方法:65例前交叉韧带损伤患者随机分为两组,其中35例接受经前内侧入路单束4股腘绳肌腱重建前交叉韧带,30例接受经胫骨隧道技术4股腘绳肌腱重建前交叉韧带,重建后平均随访16个月,分别评估膝关节的前向稳定性、旋转稳定性和膝关节的整体功能。结果与结论:最后一次随访时,经胫骨隧道组和经前内侧入路组在Lysholm评分、膝关节前向稳定性方面差异均无显著性意义(P>0.05)。经胫骨隧道组的轴移试验阳性率为23%,经前内侧入路组的阳性率为6%,两组之间差异有显著性意义(P<0.05)。结果可见经膝关节前内侧入路制作股骨隧道重建前交叉韧带,不仅可以重建膝关节的前向稳定性,还可以较好地重建膝关节的旋转稳定性。

Transplantation of single-bundle four-strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction

BACKGROUND： There are rare clinical reports addressing the establishment of the anterior cruciate ligament femoral tunnel through the anteromedial approach. OBJECTIVE： To explore the feasibility of arthroscopic single-bundle four-strand hamstring tendon for anterior cruciate ligament reconstruction through the anteromedial approach. METHODS： Sixty-five patients who underwent anterior cruciate ligament reconstruction were randomly divided into two groups. Thirty-five patients accepted single-bundle four strands hamstring tendon anterior cruciate ligament reconstruction via anteromedial approach and 30 patients accepted single-bundle four strands hamstring tendon anterior cruciate ligament reconstruction through transtibial drilling technique. The average follow-up was 16 months. Anteroposterior stability, rotational stability and overall function of the knee were assessed. RESULTS AND CONCLUSION： At the final follow-up, there was no significant difference in the anteroposterior stability and Lysholm score between transtibial drilling group and anteromedial approach group （P 0.05）. The positive rate of the pivot-shift test was 23% in transtibial drilling group and 6% in anteromedial approach group, and there was a significant difference between two groups （P 0.05）. Both anteroposterior stability and rotational stability of the knee were reconstructed by single-bundle anterior cruciate ligament reconstruction via the anteromedial approach.