前交叉韧带损伤应用自体胭绳肌肌腱镜下重建的临床研究

目的探讨前交叉韧带损伤应用四股自体胭绳肌肌腱镜下重建的方法与疗效。方法对35例前交叉韧带（ACL）损伤患者行自体四股半腱肌腱与股薄肌腱镜下重建ACL，肌腱取自同侧，将两股肌腱分别对折组成4股，编织后等长点部位钻胫骨、股骨隧道，将肌腱拉入骨隧道，分别在屈膝90°和伸膝位将移植肌腱收紧，两端可吸收空心界面螺钉内同定。结果术后随访27-60月，平均29月；术后6周关节活动达正常范围，术后抽屉试验除6例1度外，余29例均阴性；Lysholm评分，术后75～100分，平均92分，较术前52分明显提高；Tegner运动评级术后6～8级，平均7级，较术前平均3级有较大提高。结论镜下四股自体胭绳肌肌腱重建前交叉韧带，界面螺钉固定，是治疗ACL损伤的较好方法。

Clinical study of anterior cruciate ligament recon struction with grafting of four biceps femoris tendons under arthroscopy

Objective To invest igate the method and the efficacy of anterior cruciate ligament reconst ruction with grafting of four biceps femoris tendons under arthroscopy. Methods 35 patients with injury of anterior cruciate ligament （ ACL ） were operated with ACL reconstruction using a quadruple strand semitendinosus and gracilis tendon from the homo- lateral under arthroscopy. The two tendons were bended into four boundel. After the four boundel was waved, the tibial and femoral tunnel were performed by drilling at the isometric points, and then the tendons were pulled into the bone tunnels. The tendons were intensified when genufleding at 90 degree and genuextensing, and fixed with hollow interface screw. Results All patients were followed - up from 2 months to 60 months, mean time was 28 months. Articular activity reached the no rmal range at 6 weeks ＇after the operation, and 6 patients showed I degree and other 22 cases were all negative by the drawer test. Lysholm score was 75 - 100 （ mean 92 ）, and the Tegner act ivity scale was average 7 grade （6 - 8 grades） which was higher than 3grade, compared to the preoperation. Conclusion It is a good methodthat reconst ruction of ACL with grafting of four biceps femories tendons under arthroscopy.