关节镜手术治疗前交叉韧带并半月板损伤

目的 探讨关节镜手术治疗前交叉韧带(ACL)合并半月板损伤的方法及疗效.方法 关节镜下对135例ACL合并半月板损伤患者行ACL重建,同时行半月板修复或半月板修整.结果 患者均获随访,时间3～12个月,术后未出现关节粘连、血管神经损伤等并发症,半月板修整患者均无交锁且回旋挤压试验阴性.半月板修复患者3个月时随访,回旋挤压试验阳性1例;12个月时随访,回旋挤压试验阳性3例,交锁1例,两者都有1例.Lysholm评分:手术前为(46.3±6.2)分,术后6个月为(73.4±7.6)分,术后12个月为(87.8±8.2)分,术前与术后比较差异有统计学意义(P<0.01).结论 ACL与半月板常同时损伤,手术前应作好ACL重建及半月板修复或修整准备,关节镜同期治疗ACL并半月板损伤可取得较好疗效.

Arthroscopic treatment of anterior cruciate ligament injuries complicated with meniscus injuries

Objective To investigate the techniques and clinical therapeutic effects of arthroscopic treatment of ACL injuries complicated with meniscus injuries.Methods ACL reconstruction and meniscus repair or trim under arthroscopy were performed in 135 cases in our hospital.Results All patients were followed up for 3~12 months.No synathrophysis,vascular and nerve injure were observed.No cross-lock and rotator crushed test positive in patients with meniscus trimmed.Rotator crushed test positive in one case that with meniscus repaired three months after operation.Rotator crushed test positive in three case and cross-lock in one case and both Rotator crushed test positive and cross-lock in one case that with meniscus repaired twelve months after operation.Lyshlom knee score: preoperation was(46.3±6.2) and six months after operation was(73.4±7.6) and twelve months after operation was(87.8±8.2).Statistically significant differences in preoperation and 6 months or 12 months postoperation(P<0.01).Conclusions To the case of ACL combined meniscus injuries,both ACL reconstruction and meniscus repair or trim should be prepared.Simultaneous arthroscopic reconstruction of ACL and meniscus repair or trim can get good clinical result.