关节镜下同种异体骨-髌腱-骨移植重建前交叉韧带30例

目的]总结关节镜下同种异体骨-髌腱-骨移植重建前交叉韧带（anterior cruciate ligament,ACL）的临床疗效。方法]2006年1月至2008年6月我科在关节镜下应用同种异体骨-髌腱-骨移植重建ACL 30例,其中单纯ACL损伤17例,合并半月板损伤10例,合并半月板及内侧副韧带损伤3例,骨块用可吸收界面螺钉固定,对其术前和随访过程中的症状、体征及Lysholm膝关节评分以及并发症进行分析。结果]所有患者切口均Ⅰ期愈合,无明显的免疫排斥反应,无细菌或病毒感染、关节粘连及血管神经损伤等并发症发生,术后随访时间18～38个月,平均24.5个月,患者自诉膝关节不稳及无力症状消失,根据Lysholm膝关节功能评分,术前42.62±4.35分,术后89.15±3.65分,手术前后有显著性差异（P〈0.01）。结论]关节镜下可吸收界面螺钉固定异体骨-髌腱-骨移植重建ACL手术可有效改善膝关节稳定性,手术时间短,固定牢固,功能恢复满意,不需要二次手术取出内固定,是一种安全有效的ACL重建方法。

Allograft Transplanting of Bone-Patellar Tendon-Bone for Anterior Cruciate Ligament Reconstruction with Arthroscopic Debridement

Objective] To summarize the clinic effect of allograft transplanting of bone-patellar tendon-bone for Anterior Cruciate Ligament（ACL） reconstruction with arthroscopic debridement.Method]From January 2006 to June 2008,30 cases of allograft transplanting of bone-patellar tendon-bone for ACL reconstruction were carried out,including 17 cases of simple ACL injury,10 cases of meniscus injury combining,and 3 cases meniscus and medial accessory ligament injury combining.Bones could be fixed with absorbable interference screws.Symptoms before and after operations,signs,Lysholm knee score and complications were analyzed.Results]The incision of all patients were stage Ⅰ healed without obvious immunological rejection,or complications of bacterial or viral infections,joint adhesions or vascular and nerves injury,were followed up for 18 to 38 months,with an average of 24.5 months.They stated that symptoms of instability and weakness on knee disappeared.According to Lysholm knee score,pre-operation（42.62 ± 4.35） points,after（89.15 ± 3.65） points,a significant difference between before and after surgery.Conclusion] Operations of allograft transplanting of bone-patellar tendon-bone for anterior Cruciate ligament（ACL） reconstruction,with absorbable interference screws for fixation,can effectively improve stability of the knees,with short time,fixation and satisfactory functional recovery.It is a safe and effective method and no need for a second operation to remove the internal fixations of ACL reconstruction.