【摘要】 目的探讨关节镜下经髁间窝入路保留残留后交叉韧带(PCL)纤维和板股韧带重建PCL的临床效果。方法回顾性分析自2012-04—2014-10诊治的18例PCL损伤,在关节镜下单纯经髁间窝入路保留残留PCL纤维和板股韧带重建PCL。股骨隧道经前外侧入路建立并定位于距股骨髁间线软骨面约1.2 cm、距远点关节软骨面约0.8 cm处,胫骨隧道定位于胫骨后缘下1.0~1.5 cm处。移植物穿过骨隧道后股骨端用Endobutton悬吊固定,胫骨端用Bio-Intrafix及Staple门形钉固定。结果本组手术时间45~92(64.16±13.15)min。术后切口均一期愈合,X线及CT片显示骨隧道形态良好,内固定位置满意。18例均获得随访,随访时间12~18(15.66±2.06)个月。术前膝关节功能Lysholm评分19~46(31.56±8.82)分,术后12个月87~97(92.55±3.42)分;术后12个月膝关节功能Lysholm评分较术前明显提高,差异有统计学意义(t=45.450,P<0.001)。结论关节镜下经髁间窝入路保留PCL残留纤维及板股韧带重建PCL操作简单且安全,可获得良好的手术视野,重建韧带的止点定位准确,术后短期效果良好。更多还原

【Abstract】 Objective To investigate the clinical results of the arthroscopic posterior cruciate ligament(PCL) reconstruction using the transcondylar portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments. Methods Eighteen cases of PCL injury treated by the autogenous hamstring tendon reconstruction arthroscopically through the transcondylar portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments between April 2012 to October 2014 were retrospectively reviewed. The inner point of the femoral tunnel was located at 12 mm proximally to the lineae intercondyloidea cartilage and 8 mm proximally to the articular cartilage through anterolateral portal and the inner point of the tibial tunnel was located at 10 to 15 mm below the joint line in the posterior cruciate ligament facet. Tendons were fixed with Endo-button in the femur and Bio-Intrafix and Staple in the tibia. Results The operation time was 45-92(64.16 ±13.15) min. All cases achieved primary healing. Satisfactory bone tunnel and internal fixation were found in X-ray and CT.All cases were followed up for 12-18(15.66±2.06) months. Lyshlom knee score improved from a preoperative score of 19-46(31.56±8.82) to 87-97(92.55±3.42) points at 12 months postoperatively. Lyshlom knee score at 12 months postoperatively was significantly higher than that before operation with statistically significant difference( t =45.450, P <0.001). Conclusion Arthroscopic PCL reconstruction using the transcondylar portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments is simple and safe, provides adequate exposure and accurate placement of the bone tunnels, gives a satisfactory short-term clinical results.更多还原