关节镜下四股胭绳肌腱重建前交叉韧带

Arthroseopic Reconstruction of 34 Anterior Cruciate Ligament with Four-stranded Hamstring Tendon Autograft

【目的】探讨关节镜下应用自体四股胭绳肌腱重建膝关节交叉韧带（ACL）的手术方法和疗效。【方法】关节镜下34例患者以自体胭绳肌腱作为ACL的重建替代物，两端分别应用纽扣钢板和可吸收螺钉固定。【结果】所有患者均得到平均10（6～20个月）个月的随访，Lachman试验除3例阳性外，其余均为阴性。所有患者轴移试验均为阴性。Lyshlom膝关节功能评分从术前的41．79±9．23分提高至术后90．59±15．33分，手术前后比较差异有显著性（P〈0．05）。【结论】关节镜下自体胭绳肌腱移植重建前交叉韧带具有创伤小、并发症少等的优点，是恢复膝关节稳定性的可靠方法。

[Objective] To investigate the surgical techniques and treatment of arthroscopic reconstruction of anterior cruciate ligament （ACL） with four-stranded hamstring tendon autograft. [Methods] The arthroscopic reconstruction was performed in 34 cases of ACL injury. Button plate was used for the femoral tunnel fixation and bio-ahsorhahle interference screw was used for the tibial tunnel fixation. [Results] All of the 34 patients were followed up for 6 to 20 months（10 months on average）. Only 3 cases of 34 patients had positive Lachman test. The postoperative pivot shift test was negative in all cases. Lysholm score before operation was 41.79±9.23, and at the follow-up time it became 90.59 ± 15.33. There was significantly difference（ P 0.05）. [Conclusion] Four-stranded hamstring tendon autograft is a good method for arthroscopic reconstruction of ACL. It has advantages of simple operation, firm fixation and minimal invasion.