关节镜下经后中隔入路重建后交叉韧带的临床应用

Clinical application of arthroscopic trans-septal approach for reconstruction of posterior cruciate ligament

目的:探讨关节镜下经膝关节后中隔入路重建后交叉韧带的操作安全性和临床应用价值。方法:应用经膝关节后中隔的关节镜入路,对31例患者进行了后交叉韧带重建术。术后早期物理治疗及康复训练,采用Lysholm评分法随访分析膝关节功能。结果:无术中神经血管损伤及术后并发症发生,术后随访6～22个月,患者手术前后Lysholm膝关节评分分别为(43.65±12.21)和(89.27±8.96)分。结论:关节镜下经后中隔入路重建后交叉韧带,可清楚观察膝关节后室腔内结构,视野清晰,扩大了关节镜下手术操作空间,操作具有安全性,与术后早期合理的康复治疗结合,效果良好。

Objective： To evaluate the safety and clinical value of arthroscopic trans-septal approach for the reconstruction of posterior cruciate ligament （PCL）. Methods： Thirty-one patients underwent PCL reconstruction by arthroscopic transeptal approach and postoperative rehabilitation program. Lysholm scores were recorded for evaluating the knee function. Results： No vascular and neurological complications directly related to the surgical technique were found during the 6 to 22-month follow-up. Lysholm scores were （43.65 ± 12.21 ） and （89.27 ±8.9 ） before and after the surgery, respectively. Conclusion： The arthroscopic trans-septal approach for PCL reconstruction is feasible and safe. This approach provides a broader field of vision and enough room for surgical instruments. The clinical outcome is better when the rehabilitation program is performed appropriately after PCL reconstruction,