关节镜下腓骨长肌腱重建前交叉韧带的临床研究

The clinical study of anterior cruciate ligament reconstruction with the peroneus longus tendon under arthroscopy

目的初步探讨关节镜辅助下自体腓骨长肌腱重建膝关节前交叉韧带的临床疗效。方法 选取2013年4月~2015年9月于我科收治的膝关节前交叉韧带损伤患者25例,均在关节镜辅助下取自体腓骨长肌腱重建前交叉韧带,术后评价根据膝关节临床检查、Lysholm膝关节功能评分及AOFAS踝关节功能评分。结果 所有病例均获得随访,随访时间10~22个月,平均14.7个月,抽屉实验及Lachman试验阴性,无膝关节不稳症状,术后6月根据Lysholm膝关节功能评分评估,优13例,良10例,可2例,优良率92.0%,术后Lysholm膝关节功能评分明显高于术前,差异有统计学意义（P〈0.05）。术后AOFAS踝关节功能评分和术前比较无明显差异（P〉0.05）。结论 关节镜辅助下自体腓骨长肌腱重建膝关节前交叉韧带的疗效令人满意,取腓骨长肌后对踝关节功能无明显影响。

Objective To investigate the early clinical effect of anterior cruciate ligament reconstruction with the per- oneus longus tendon under arthroscopy. Methods From April 2013 to September 2015,25 patients of anterior cruciate ligament injuries were treated with peroneus longus tendon under arthroscopy. All patients were evaluated in the fol- lowing objective indexes after the operation respectively, including clinical evaluations of knee joint,Lysholm knee score and the American Orthopedic Foot and Ankle Society ankle-hind foot scale （AOFAS）. Results All patient got bone union,a follow-up of 10-22 months were done in the 25 patients, the average 14.7 months. The Lachman test and front of knee was negative, no knee joint relaxation or extension-restriction was found. In accordance with criteria for assessing the efficacy of Lysholm and 6 months after surgery, excellent in 13 cases, good in 10 cases, and fair in 2 cases, the excellent and good rate of 92.0%. Postoperative Lysholm knee function scores were significantly higher than the preoperative, the differences were statistically significant（P〈0.05）. There was no significant difference in the func- tional score of the ankle joint after operation （P〉0.05）. Conclusion Reconstruction of anterior cruciate ligament with peroneus longus tendon under arthroscopy can achieve excellent clinical results, And its resection has no major influ- ence for ankle joint .