半腱肌腱股薄肌腱在重建前交叉韧带中的运用

Reconstruction of anterior cruciate ligament with semitendinosus and gracilis tendon graft

目的:探讨用无内固定物的半腱肌腱股薄肌腱重建前交叉韧带的临床运用和效果。方法:南京医科大学第一附属医院自2002年12月至2004年6月对33例前交叉韧带损伤的患者进行了无内固定物的半腱肌腱股薄肌腱重建前交叉韧带术,其中13例移植肌腱采用二股半腱肌腱和二股股薄肌腱,另20例仅为二股半腱肌腱,术前和术后进行Lachman试验评估膝关节的稳定性,用Lysholm评分方法评定膝关节功能。结果:术前Lachman试验均为阳性,术后29例为阴性,4例为阳性。术前Lysholm评分为36￣57分,术后Lysholm评分为71￣96分。结论:无内固定物的半腱肌腱股薄肌腱重建前交叉韧带为生物固定,固定可靠,费用少,短期效果好,中长期效果有待观察。

Objection： To study the clinic application and curative effect of anterior cruciate ligament reconstruction with semitendinosus and gracilis tendon graft. Method： 33 patients of ACL rupture have been operated ACL reconstruction with non-fixity hamstring tendon graft from December 2002 to June 2004. Among these cases, the graft of 2 bands of semitendinosus and 2 bands of gracilis were used in 13 patients,and the graft of only 2 bands of semitendinosus were used in other 20 patients. The stability of knee joint was evaluated with lachman test and the function of knee joint was evaluated with Lysholm knee scoring scale. Results： Lachman test were all positive preoperatively, while 29 cases （87.8%） negative and 4 cases （12.2%） positive 6 months postoperatively. Lysholm knee scores were 36-57 preoperatively in contrast to 71-96 postoperatively. Conclusion： There are such advantages of reconstructing ACL with non-fixity semitendinosus and gracilis graft as follows：bio-fixation, reliable fixation, low expense and satisfying effect in early stage postoperatively. It needs more time to observe the long-term effect.