RIGIDfix与Intrafix螺钉应用于前、后交叉韧带一期重建的临床观察

Arthroscopic RIGIDfix and Intrafix Pins for Anterior and Posterior Cruciate Ligament Reconstruction

目的探讨关节镜下应用RIGIDfix交叉钉与Intrafix膨胀挤压钉一期重建前、后交叉韧带及其近期临床疗效观察。方法关节镜下采用异体胫骨前肌腱联合应用RIGIDfix交叉钉与Intrafix膨胀挤压钉对16例多发韧带损伤患者行前、后交叉韧带一期重建术,术后即行膝关节稳定性检查,所有患者术后随访时行三维CT或MRI检查,并按照Lysholm评分、Irgang评分、IKDC膝关节评分标准及JOA膝关节韧带损伤治疗效果判定标准进行疗效评价。结果16例患者均获得随访,随访时间6～16个月(平均9个月)。IKDC评分活动水平正常13例(81.25%);Lysholm评分从术前(46.8±6.6)分提高到术后(83.2±8.8)分;Irgang评分从术前(44.2±7.3)分提高到术后(77.9±8.3)分。JOA评分从术前(33.8±4.6)分提高到术后(82.6±7.5)分。结论关节镜下采用异体胫骨前肌腱联合应用RIGIDfix交叉钉与Intrafix膨胀挤压钉一期重建前、后交叉韧带,固定确实,重建后膝关节稳定性良好。

Objective To evaluate the therapeutic effect of anterior and posterior cruciate ligament （ACL and PCL） reconstruction with allograft hamstring by using absorbable RIGIDfix cross pins and Intrafix pins. Methods 16 cases were accepted ACL and PCL reconstruction with allo-graft hamstring using absorbable RIGIDfix cross pins and Intrafix pins. The evaluation methods involved clinical examination, abduction stress test,anterior drawer test （ADT）,posterior drawer test （PDT） and Laehman test,radiographic evaluation such as CT or MRI, Lysholm knee scores and JOA knee scores. Results All of the 16 patients were followed up for an average time of 9 months （ranging from 6-16 months）. All patients were in good position radiographically and had comfortable joint function,with Lysholm score （83.6±9.2） and Irgang score（78.8±8.2）. 13 patients got normal IKDC Score（81.25%）. In 2 patients who had MCL injury,the range of genuflex was limited to 70° 3 months later because of myositis ossificans; 1 case felt instability of the injury knee and 2 cases felt pain sometimes. Conclusion The reconstruction of ACL and PCL at the same time with allo-graft hamstring using absorbable RIGIDfix cross pins and Intrafix anchorages is feasible, safe and stable. The clinical result of our test might indicate an optimistic application in the future.