无内固定物腘绳肌腱重建前交叉韧带临床探讨

Clinical Study on Reconstruction of Anterior Cruciate Ligament with Non-Fixity Hamstring Tendon Graft

目的探讨用无内固定物的绳肌腱重建前交叉韧带的临床运用和效果。方法自2002年12月～2004年6月对33例前交叉韧带损伤进行了无内固定物的绳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绳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。

Objective To investigate the clinical application and curative effect of the reconstruction of the anterior cruciate ligament （ACL） with non- fixity hamstring tendon graft. Methods Thirty- three patients with ACL rupture underwent ACL reconstruction with non- fixity hamstring tendon graft from December 2002 to June 2004. Among these cases, two- stranded semitendinosus graft and two- stranded gracilis graft were used in 13 patients while only two- stranded semitendinosus graft were used in other 20 patients. The stability of knee joint was evaluated with Lachman test while the function of knee joint was evaluated with Lysholm knee scoring scale both preoperatively and postoperatively. Results Lachman test were positive in all patients preoperatively while it was negative in 29 （87.8 % ） patients and positive in 4 （ 12.2 % ） patients 6 months postoperatively. Lysholm knee scores ranged from 36 to 57 preoperatively in contrast to between 71 and 96 postoperatively. Conclusion The reconstruction of ACL with non - fixity hamstring tendon graft has the advantages such as bio- fixation, reliable fixation, low expense and satisfactory effect in early stage postoperatively. It needs more time to observe the middle and long term effect.