关节镜下保留止点半腱肌及股薄肌肌腱重建前交叉韧带

Arthroscopic reconstruction of anterior cruciate ligament with semitendinosus muscle tendon and gracilis muscle tendon of keeping insertion

目的:介绍在关节镜下采用保留止点半腱肌及股薄肌肌腱重建前交叉韧带的手术方法,探讨其临床效果。方法:对51例单纯前交叉韧带断裂的患者,在关节镜下利用保留止点半腱肌及股薄肌四股肌腱进行重建,术后进行1年以上的随访,了解膝关节功能。结果:术后3个月所有患者膝关节均无伸屈受限,膝关节屈膝活动度均大于120°。术后1年,患肢的股四头肌-腘绳肌力矩比超过正常侧的90%;屈膝70°时前抽屉试验I度阳性,Lachman试验阳性6例,其余为均为阴性;屈膝30°时前抽屉试验I度阳性,Lach-man试验阳性2例,其余为阴性;膝关节功能Lysholm评分为(90.7±2.3)。结论:在关节镜下利用保留止点半腱肌及股薄肌四股肌腱重建前交叉韧带、方法简单、创伤小、并发症少、有利于愈合,能够可靠恢复膝关节功能。

Objective To study the clinical outcome of arthroscopic reconstruction of anterior cruciate ligament with semitendinosns muscle tendon and gracilis muscle tendon of keeping insertion. Method 51 cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with semitendinosns muscle tendon and gracilis muscle tendon of insertion.The patients were followed up for more than one year and evaluated for knee function. Results No extension limitation occurred and the flexion degree were more than 120°in all cases after 3 months postoperatively. One year after operation,the semitendinosns muscle tendon / gracilis muscle tendon peak torque ratio reached more than 90% of the uninjured leg; anterior drawer test and Lachman test at 70°flexion were negative in all but 6 cases, who had one-degree instability; anterior drawer test and Lachman test at 30°flexion were one degree positive in six cases, and negative in other cases; The Lysholm knee score were （90.7±2.3）. Conclusion Arthroscopic reconstruction of anterior cruciate ligament with semitendinosns muscle tendon and gracilis muscle tendon of keeping insertion is relatively simple, and is reliable for the restoration of knee function.