关节镜下自体骨-髌腱-骨重建膝前交叉韧带的疗效观察

目的探讨关节镜下骨-髌腱-骨治疗膝前交叉韧带损伤的手术方法和疗效。方法对25例前交叉韧带完全损伤患者实施关节镜下骨-髌腱-骨静力重建。结果随访2~38个月,24例膝关节不稳症状消失,伸屈度0°~107°,平均（96.8±2.11）°。4例术后出现不同程度髌前疼痛,1例术后半年关节反复肿痛,关节镜下证实重建肌腱股骨端断裂,1例并发膝关节伸直型僵直,经关节镜下松解后有效改善。根据Lysholm膝关节评分法,患膝评分由术前（45.45±1.18）分提高到术后（80.77±1.42）分。结论关节镜下自体骨-髌腱-骨重建前交叉韧带取材方便,肌腱强度符合重建材料要求,患膝不稳有效改善。

Analysis of curative effect of arthroscopic reconstruction of anterior cruciate ligament with Bone-pateller tendon-bone

Objective To explore the method and the clinical effect of the arthroscopic reconstruction of anterior cruciate ligament with bone-pateller tendon-bone（B-PT-B）.Methods 25 patients with complete rupture of anterior cruciate ligament were treated by arthroscopic reconstruction with B-PT-B.Results Following-up ranged from 2 to 38 months.The symptoms of instable knees among 24 patients disappeared.The ROM of this group was from 0° to 107°（mean 96.8±2.11°）.4 patients had a sub-patellar pain after the surgery.One patient had a recurrent welling and pain knee after 6 months postoperationally due to a rapture of the femoral end of the reconstructed tedon.Another patient with a stiff knee had a functional improvement after arthrocopic release.According to the Lysholm knee scale score,the scores rose from 45.45±1.18 to 80.77±1.42 after the surgery.Conclusion The arthroscopic reconstruction of anterior cruciate ligament with B-PT-B is convenient.The tendon intensity fits the needs of reconstruction materials,so the instability of knee can be improved efficiently.