可吸收界面螺钉重建膝关节前交叉韧带术后并发症

Complications After Absorbable Interference Screw Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction

目的探讨采用可吸收界面螺钉重建膝关节前交叉韧带术后可能发生的并发症。方法采用PolyL-lacticacid(聚左旋乳酸)材料制作的可吸收界面螺钉重建膝关节前交叉韧带36例,术后6周、3个月、6个月、1年后定期进行物理检查、关节活动测量仪(KT2000)及摄X线片检查。结果本组均获随访,术后6周复查发现有关节肿胀及皮肤温度升高等滑膜炎体征2例(5%),其中1例经非手术治疗后痊愈,但另1例经KT2000检查及物理检查有关节松弛。术后股骨远端及胫骨近端出现弥漫性骨质吸收现象有3例(8%)。术后20个月后复查发现有1例胫骨隧道轻度扩大并伴伸直受限(2%)。结论不论是用金属还是可吸收界面螺钉重建都有可能出现隧道扩大及关节松弛等并发症。但是术后反应性滑膜炎、股骨远端及胫骨近端弥漫性骨吸收现象是否与采用可吸收界面螺钉直接相关,还有待于进一步观察及研究。

Objective To investigate the complications in arthroscopic anterior cruciate ligament reconstruction by using absorbable interference screw fixation. Methods The study was based on 36 patients who underwent arthroscopic anterior cruciate ligament reconstruc- tion with absorbable screws. Physical examinations, radiographic studies and KT 2000 were taken postoperatively at 6 weeks, 3 months, 6 months, and 1 year afterwards every year. Results Among the 36 patients, synovitis was developed in two patients （5 9b ） 6 weeks after surgery. One patient was treated conservatively, and the symptom was improved. The other patient showed anterior instability. Three patients （8 % ） developed diffuse patchy osteoporosis. One patient developed tunnel widening at tibial side with 10 degrees flexion contracture of the knee （2 % ）. Conclusion One patient with tunnel widening and one with laxity can also be resulted from metallic interference screws. But two patients with synovitis and three patients with diffuse patchy osteopososis can be complications due to absorbable interference screw fixation. Close follow up observation is needed.