关节镜下单束自体肌腱的前交叉韧带重建

Arthroscopic single-bundle reconstruction of anterior cruciate ligament with autogenous tendons

关键词:  前交叉韧带  膝损伤  关节镜检查

Key words:  anterior cruciate ligament  knee injuries  arthroscopy

摘要:

目的探讨关节镜下单束自体肌腱重建前交叉韧带（anterior cruciate ligament,ACL）的临床疗效。方法回顾性分析2009年2月至2011年9月23例ACL损伤患者,男15例,女8例;年龄21-53岁,平均32岁;受伤到手术时间为5-40周,平均13周。采用关节镜下保留胫骨残端,取自体半腱肌腱和或股薄肌腱重建ACL。结果23例患者术后获平均18个月（6-32个月）随访,末次随访21例患者（91.3%）Lachmen实验均为阴性。Lysholm评分Tegner评分IKDC主观评分明显改善,轴移实验检查均为阴性,膝关节活动度正常。结论关节镜下单束自体肌腱重建ACL,有效恢复膝关节稳定性,临床效果可靠。

Abstract:

Objective To evaluate clinical efficacy of arthroscopic single-bundle reconstruction of anterior cruciate ligament（ACL） with autogenous tendons.Methods Twenty three patients with ACL injury were treated in our department from February 2009 to September 2011.The tibial remnant was reserved and the ACL was reconstructed with autogenous semitendinosus or gracilis tendon under arthroscopy.Results The patients were followed up for an average 18（6-32） months.At the last follow-up,21 patients（91.3%） had negative Lachmen results,and only 2 patients（8.7%） had positive Lachmen results.The Lysholm score,Tegner score and International Knee Documentation Committee（IKDC） grade were improved postoperatively.All the patients showed a negative pivot shift test and a normal range of motion.Conclusion Arthroscopic ACL reconstruction with autogenous tendons can contribute to the recovery of knee joint stability and lead to satisfactory clinical outcomes.