关节镜下应用EndoPearl与Intrafix固定双侧绳肌肌腱一期重建膝关节前后交叉韧带

Arthroscopic Reconstruction of Anterior Cruciate Ligament and Posterior Cruciate Ligament with Bilateral Hamstring Tendons Fixed by EndoPearl and Intrafix

目的探讨关节镜下应用EndoPearl与Intrafix固定双侧腘绳肌肌腱同时重建膝关节前后交叉韧带的近期临床效果。方法对2004年6月～2005年3月收治的10例膝关节前后交叉韧带同时断裂的患者，切取双侧腘绳肌腱，2条半腱肌腱和2条股薄肌腱分别对折成四束，折端固定同直径EndoPearl。关节镜下利用两组移植物同时分别重建膝前后交叉韧带。股骨端应用可吸收界面螺钉顶压固定EndoPearl与移植肌腱，胫骨端应用Intrafix固定四柬肌腱。结果10例均获得随访，平均7．5个月（6～15个月），切口Ⅰ期愈合，无感染。其中新鲜损伤4例，陈旧性损伤6例，合并后外侧复合体损伤3例，均予同期修复，合并内侧副韧损伤6例，未予特殊处理，5例曾急诊修复胭动静脉。术后3个月膝关节活动范围均超过120°，无伸膝受限，后抽屉试验Ⅰ度阳性2例，其余为阴性；Lyshlom评分（92．6±3．2）分。结论关节镜下应用EndoPearl与Intrafix固定双侧腘绳肌肌腱同时重建膝关节前后交叉韧带方法确切，可有效恢复膝关节功能。

Objective To evaluate the early stage follow- up results of an alternative procedure of arthroscopic anterior cruciate ligament （ACL） and posterior cruciate ligament （PCL） reconstruction using bilateral hamstring tendons fixed by EndoPearl and Intrafix. Methods From June 2004 to March 2005, 10 patients with both ACL and PCL injuries were treated as following： the quadrisemitendinosns and quadrigracilis were transplanted under arthroscope and EndoPearl and grafting were fixed by absorbable interference screws in femur and fixed by Intrafix in tibia. Results All patients were followed up for 6 months to 15 months, averaging 7.5 months. The incision of all the patients healed without infection. There were 4 fresh and 6 old injuries. No extension limitation occurred and the flexion degree were more than 120° in all patients three months postoperatively. The posterior drawer test was negative in all but 2 patients who had one degree instability. The Lysholrn knee score was 92.6 ± 3.2. Conclusion Arthroscopic reconstruction of the ACL and PCL with bilateral hamstring tendons fixed by EndoPearl and Intrafix is effective and reliable for the restoration of knee function.