关节镜下膝关节前、后交叉韧带重建53例

Arthroscopic anterior/posterior cruciate ligament reconstruction:53 cases report

目的总结关节镜下前、后交叉韧带(ACL、PCL)及膝内外侧复合体重建的经验。方法关节镜下移植中1/3骨-髌腱-骨组织、4股腘绳肌腱及LARS人工韧带重建膝关节ACL、PCL。合并膝内、外侧结构损伤患者在重建的同时进行膝关节侧副韧带和关节囊的修补。术后佩戴可调式膝关节固定带3个月行康复训练。结果53例随访2个月～5年4个月,Lysholm评分由术前平均(20±4.6)分提高到(85±7.3)分。所有患者术前抽屉试验及Lachman试验存在阳性体征,术后1例后抽屉试验阳性,4例Lachman试验弱阳性。所有患者关节功能明显改善。结论在关节镜直视下交叉韧带重建能准确定位ACL、PCL解剖止点,具有损伤小,关节粘连率低,恢复快的优点,能达到坚强固定,早期功能锻炼的目的。

Objective To summarize arthroscopic reconstruction of ACL/PCL in knee joints. Methods Reconstruction of the anterior/posterior cruciate ligament was performed with bone-patellar tendon-bone, four-strand hamstring tendon autograft and LARS artificial ligament transplantation under arthroscopy, respectively. Simultaneous repair of collateral ligaments and capsule were performed if needed. Rehabilitation was trained for 3 months with the adjustable knee external frame support. Results 53 patients got average follow-up of 3.4 years. The Lysholm score of knee was improved from （20±4.6） to （85±7.3） on average. All cases had positive anterior/posterior drawer test and Lachman test preoperatively ; only 1 case had positive posterior drawer test and 4 case had slight positive Lachman test at the last follow-up. All patients knee＇s function was greatly improved. Conclusions Arthroscopic reconstruction of ACL/PCL in knee joints has the advantages of accurate localization of the anatomic ACL/PCL insertions, minimal trauma, rapid recovery, rigid fixation and allowance of early exercises.