股薄肌和半腱肌移位修复膝内侧副韧带损伤

Gracilis and semitendinous transfer to repair the medial collateral ligament injury of knee

目的探讨股薄肌和半腱肌移位在附着处对膝内侧副韧带断裂进行修复重建的方法和疗效。方法手术治疗32例膝内侧副韧带断裂患者,对断端可直接修复者,同时切取股薄肌肌腱移位加强修复该韧带;对韧带断端缺损直接缝合困难者,采用半腱肌肌腱转位替代该韧带。结果28例获得随访,时间1～7(3±0.5)年,按改良Lysholm-Scale评分标准:优23例,良3例,可1例,差1例。结论膝内侧副韧带损伤应早期手术修复以获得较好疗效,股薄肌和半腱肌止点接近膝内侧副韧带止点,强度好,移位后在解剖学位置上加强修复该韧带,发挥了膝内侧副韧带固有的生物学效能,关节功能恢复满意。

Objective To explore the method and effect of gracilis and semitedinous transfer in the treatment of medial collateral ligament rupture of knee. Methods 32 cases of knee medial collateral ligament ruptures were treated surgically. In patients with the terminals of rupture could be sutured end-to-end, gracilis muscle was transferred to strengthen the ligament; In patients with the terminals of rupture could not be sutured end-to-end, semitendinous muscle was transferred to strengthen the ligament. Results 28 patients were followed up for 1 - 7 （3±0. 5） years. According to the improved Lysholm Scale score standards, the results were excellent in 23 cases, good in 3, fair in 1, and poor in 1. Conclusions Medial collateral ligament injury of knee should be early surgical repaired. The gracilis muscle tendon and semitendinous are close to the knee medial collateral ligament. The strength is good. Anatomical repair can be abtained by transfer the two tendons with satisfactory effect.