骨隧道定位在关节镜下前交叉韧带重建术中的应用

目的观察骨隧道定位用于关节镜下前交叉韧带（ACL）重建术中的效果。方法选择ACL损伤患者52例,以自体4股等长半腱肌腱作为替代移植物,选择右膝11点、左膝1点为股骨隧道定位点,髁间窝顶线后侧4-5 mm为胫骨隧道定位点,于关节镜下行ACL重建。术前、术后行前抽屉试验和Lachman试验检查膝关节稳定性,采用Lysholm膝关节功能评分表评价膝关节功能。结果随访6个月-4 a,平均1.8 a。52例患者术前前抽屉试验和Lachman试验均为阳性;术后阳性者3例,可疑阳性者8例,余均为阴性。术后8~12周膝关节屈伸功能恢复正常;Lysholm评分明显高于术前,P〈0.05。未出现撞击综合征及其他并发症。结论精确的骨隧道定位是关节镜下重建膝关节ACL的关键。

Application of bone tunnels localizations in arthroscopic anterior cruciate ligament reconstruction

Objective To explore the therapeutic efficacy of accurate position of bone tunnels in anterior cruciate ligament（ACL）reconstruction under knee arthroscope.Methods Fifty-two cases of ruptured ACL were involved,semitendinosus tendon were chosen as autografts.The right knee 11 o′clock or the left knee 1 o′clock were chosen as the femoral tunnels placement,and the top line of the intercondylar fossa back of 4~5 mm as the tibial tunnel positioned spots,ACL reconstruction was performed under arthroscope.The anterior drawer test and Lachman test were used to check the stability of the knee before and after surgery,the Lysholm knee score was used to evaluate the function of knee.Results The time of follow-up visit was 6-48 months（with the average of 1.8 a）.The preoperative anterior drawer test and Lachman tests were positive in all 52 patients.The drawer test and Lachman test were positive in 3 cases and suspiciously positive in 8 cases after surgery.The flexion-extension function of the knees return to normal 8-12 weeks after surgery;the postoperative Lysholm knee score was significantly higher than that before surgery,P〈0.05.No impact syndrome and other complications were found.Conclusion Correct placement of the bone tunnel is prerequisite to a successful ACL reconstruction under arthroscope.