同种异体髌腱重建前后交叉韧带的疗效观察

Clinical Treatment of Combined Reconstruction of Anterior Cruciate Ligament and Posterior Cruciate Ligament with Allogenic Patellar Tendons

目的探讨同种异体髌腱同时重建膝关节前交叉韧带与后交叉韧带的临床疗效。方法我院确诊为前、后交叉韧带同时损伤的患者39例，其中合并内侧副韧带损伤28例，外侧副韧带损伤2例。应用由山西骨组织库提供的同种异体髌腱移植物进行膝关节前后交叉韧带同时重建，用挤压界面螺钉固定，同时处理合并伤，术后膝关节支具固定。本组患者中38例得到随访，1例失访。术后随访7～48个月，平均随访18个月。结果采用Lysholm膝关节评分标准评分，平均积分由术前的22分提高到术后的84分，全部病例均无并发损伤和排异反应，术后无伸膝受限，屈膝活动度为100°～120°，术后6～8个月基本恢复正常工作和生活。结论关节镜下同种异体髌腱重建膝关节前、后交叉韧带能较好的恢复膝关节的稳定性和功能。

Objective To evaluate the clinical outcomes of combined reconstruction of anterior cruciate ligament （ACL） and posterior cruciate ligament （PCL） with allogenic patellar tendons. Methods 39 patients of combined ACL and PCL injury were enrolled in this study,in which 28 cases were combined with medial collaternal ligament injuries and 2 cases with lateral collaternal ligament injuries. All the ACL and PCL were reconstructed with allogenic patellar tendons ,fixed with interference screws and the combined injuries were treated at the same time. 38 cases were followed up 7-48 months with an average of 18 months,only 1 case lost follow up. Results The clinical outcomes were evaluated with Lysholm knee scoring system,the average score were 84 points postoperatively compared to 22 points preoperatively. There were no complications injures or rejection reactions occurred and the knee flexion were 100°-120°without restrictions. All the patients regained normal work and daily life movements after 6--8 months. Conclusion Reconstruction of ACL and PCL with allogenic patellar tendons arthroscopieally could regain the functions and stability of the knee joints with satisfactory outcomes.