关节镜下横杆悬挂法重建膝前交叉韧带临床研究

Clinical Investigation on Arthroscopic ACL Reconstruction with Semitendinosus and Gracilis Tendon Using Cross-pin Fixation

目的:介绍关节镜下横杆悬挂固定法(ArthrexTransFixⅡ法)固定移植的半腱肌腱、股薄肌腱重建膝关节前交叉韧带的方法,并对其中期临床疗效进行了分析。方法:从2003年6月至2005年9月,采用横杆悬挂固定法固定移植的半腱肌、股薄肌腱重建膝关节前交叉韧带123例。其中,男性100例,女性23例。年龄16～57岁,平均年龄28.5岁。左膝60例,右膝63例。平均病程12.3个月。取患膝半腱肌腱、股薄肌腱并修整、编织缝合后植入骨道,股骨骨道的移植物行横杆悬挂法固定,胫骨端用生物可吸收挤压钉加门形钉固定。结果:123例患者中,112例获得随访,随访时间6～27个月,平均18.5个月。随访病例术前Lysholm评分为53.2±3.2分,随访时Lysholm评分为93.4±2.3分,两者相比有显著性差异(P<0.05)。结论:关节镜下横杆悬挂法绳肌移植重建膝前交叉韧带是一种微创、疗效确切的方法。

Objective ACL reconstruction with semitendinosus and gracilis using Arthrex TransFix Ⅱ fixation was reported. The medium - term of clinical outcome was investigated. Methods From June of 2003 to September of 2005, semitendinosus and gracilis tendon and technique of TransFix fixation was used for reconstructing ACL in 123 cases. Of 123 cases, there were 100 male and 23 female, aged from 16 to 57 years（average 28.5 years old） ; including 60 left knees and 63 right knees. Average course of disease was 12.3 months. Semitendinosus and gracilis tendons of the injured knee were taken, then trimmed and sutured as grafts and implanted into bone tunnel. TransFix was used for the femoral tunnel fixation and bioabsorabable interference screw and Spiked Ligament Staple were applied for the tibial tunnel fixation. Results 112 cases was followed up, the follow - up duration ranged from 6 to 27 months（average 18.5 months）. Lysholm score were 53.2± 3.2 and 93.4± 2.3, respectively before operation and at the time of follow- up. Paired t- test showed that Lysholm score were significantly difference after surgery（ P 〈 0.05）. Conclusion Using hamstring and TransFix for ACL reconstruction under arthroscopy was a Key words anterior cruciate ligament, mini - invasive technique and its clinical outcome was assured.