关节镜下自体Ha mstring腱重建前交叉韧带的应用

Clinical research on the arthroscopic hamstring tendon autograft for reconstruction of the anterior cruciate ligament.

目的 探讨关节镜下自体Hamstring腱重建前交叉韧带 (AnteriorCruciateLigament,ACL)的临床方法和疗效。 方法 2 2例ACL损伤 ,年龄 17岁～ 5 0岁 ,平均 30 7岁 ,进行关节镜下自体Ham string腱ACL重建术。 结果 本组 2 2例术后膝关节均获正常活动范围。术后Lachmen试验 :19例≤ 1+,2例 2 +,1例 3+。轴移试验 :2 0例阴性或可疑 ,2例阳性。术后Lysholm评分为 (87 7± 9 6 )分 ,较术前 (5 4 4± 12 1)分显著提高 (t =2 33,p <0 0 5 )。术后Tegner活动评分为 (5 1± 1 3)分 ,较术前 (2 8±0 8)分显著提高 (t=4 36 ,p <0 0 1)。 19例X线内固定物的位置良好 ,3例内固定物的位置欠佳。 3例胫部伤口早期感染 ,经伤口处理愈合。 2 2例随访 7月～ 2 5月 ,平均 15 7月。 结论 关节镜下自体Ham string腱重建ACL是一种治疗急慢性ACL损伤的有前景的术式。

Objective To explore the surgical technique and clinical effect of arthroscopic hamstring tendon autograft on reconstruction anterior cruciate ligament (ACL). Methods 22 patients underwent ACL reconstruction with hamstring tendon autograft under arthroscopy. The mean age was 30 7 years (17years～50 years). Results The motion range of knee joint of all cases was normal or nearly normal. The postoperative Lachman test was ≤1+ in 19 patients, 2+ in 2 patients and 3+ in 1 patient. 20 patients also showed an absent pivot shift. The postoperative Lysholm score was (87 7±9 6)points, and the postoperative score increased significantly compared with the preoperative score ( t =2 33, P <0 05).The postoperative Tegner activity grading scale was(5 1±1 3)points, and the postoperative grading scale increased distinctly compared with the preoperative one( t =4 36, P <0 01). The mean follow-up period was 15 7 months ( 7months～25 months). Conclusions The arthroscopic ACL reconstruction using hamstring tendons contributes to a better result and is an alternative method.