【作者】 赵金忠； 蒋垚； 沈灏；

【Author】 ZHAO Jin-zhong, JIANG Yao, SHEN Hao. Department of Orthopaedics, Shanghai Sixth Peoples Hospital, Shanghai 200233, China

【机构】 上海第六人民医院骨科；

【摘要】 目的:关节镜下采用胭绳肌肌腱和微型钢板纽扣同时重建前后十字韧带,并对重建效果进行评估。方法:对12例前后十字韧带损伤患者,在关节镜下采用同侧半腱肌肌腱和微型钢板纽扣重建前十字韧带,采用对侧半腱肌肌腱、股薄肌肌腱和微型钢板纽扣重建后十字韧带。其中2例还同时行后外侧韧带结构重建,1例同时行后内侧韧带结构重建术后随访12-24个月, 采用IKDC和Lysholm膝关节功能评分表对患膝功能进行评估,通过KT-1000检查了解膝关节的前后松弛度。结果:术后无伸膝受限,屈膝活动度120°-140°,平均128°终末随访时IKDC评分为A4例(33．3％),B7例(58．3％),C1例(8．3％)屈膝25°位KT-1000检查,双侧膝关节前向松弛度差异小于2mm者8例,3-5mm者3例,7 mm者1例;屈膝70°位检查,双侧胫骨结节后坠差异为0-2mm者9例,2-4mm者3例陈旧性损伤患者术前Lysholm膝关节功能评分为 (66．5±3．1)分,终末随访时为(93．8±3．5)分,差异具有非常显著性(t=5．376,P<0．01)10例患者(83．3％)恢复了原来的运动水平,2例患者(16．7％)运动水平较前有所降低。结论:在关节镜下采用双侧腘绳肌肌腱和微型钢板纽扣同时重建前后十字韧带,能够较满意地恢复膝关节功能。更多还原

【Abstract】 Objective To introduce the simultaneous arthroscopic reconstruction techniques of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with hamstring tendons, fixed with mini-plates and buttons, and to evaluate the results of simultanous ACL && PCL reconstruction. Methods Twelve cases of ACL and PCL ruptures were reconstructed arthroscopically with mini-plates and buttons fixed hamstring tendons in one stage. Semitendinous tendons of the injured leg were used for ACL reconstructions, while semitendinous and gracilis tendons of the uninjured leg were used for PCL reconstructions. The posterolateral ligament complex in two cases and posteromedial ligament complex in one case were also reconstructed. The patients were followed up for twelve to twenty-four months. The IKDC and Lysholm knee score scale were used for function evaluation. The anterior and posterior knee laxity was examined by KT-1000. Results There was no knee extension limitation. Knee flexion was between 120° and 140°, with an average of 128°. According to the last IKDC evaluation, 4 cases (33.3%) were graded as A, 7 cases (58.3%) B, and 1 case (8.3%) C. KT-1000 examination at 25° flexion showed that the side difference of anterior laxity was below 2 mm in 8 cases, was 3-5 mm in 3 cases, and 7 mm in 1 case. The side difference of posterior sag at 70° flexion was 0-2 mm in 9 cases, 2-4 mm in 3 cases. The Lysholm score of the nine chronic cases was 66.5±3.1 before surgery, and 93.8±3.5 at the last follow up. Statistically the difference between the two Lysholm scores has prominent significance (t=5.376, P< 0.01). Conclusion Simultaneous arthroscopic reconstruction of both ACL and PCL with mini-plates and buttons fixed hamstring tendons and is reliable for knee function restoration.更多还原