19例异体跟腱关节镜下重建膝后交叉韧带临床分析

Posterior cruciate ligament reconstruction with aliogeulc achilles tendon under arthroscopy in 19 cases

目的探讨关节镜下应用同种异体跟腱重建膝后交叉韧带（PCL）的方法及疗效。方法回顾2004年1月至2008年1月在关节镜下应用同种异体跟腱重建PCL19例，术中切取标准化的柱状跟骨，确保移植物在股骨及胫骨骨道内紧密固定，术前及术后12个月时用Lysholm评分评定膝关节功能。结果随访19例患者术前平均评分61分（54～69分），术后12个月时92分（76～95分），总优良率89％。结论关节镜下应用同种异体跟腱重建PCL可有效改善膝关节稳定性。术中股骨及胫骨骨道精确定位、术后系统康复治疗是确保手术疗效的关键。

Objective To evaluate the method and its effect of posterior erueiate ligament （PCL） reconstruction with allogenie aehiUes tendon under arthroseopy. Methods We reviewed ninteen patients who were underwent arthroseopie PCL reconstruction using the allogenic achilles tendon from January 2004 to January 2008. A special technique was allowed for the standardized harvest of cylindrical ealcaneus bone, ensuring adequate press-fit fixation within the femoral and tibial tunnels, and the function of the knee joint was assessed according to the Lysholm score. Results Ninteen patients were followed up. Before operation, the mean Lysholm score was 61 points （54 ～ 69 points）. Twelve months later after operation, the score was 92 points （76 ～95 points）. The excellent and good results were obtained in 89 %. Conclusion Our study indicates that arthroscopic PCL reconstruction with allogenic achilles tendon can effectively improve the stability of the knee joint. It is important to achieve favorable result that the precise position is taken in the femoral and tibial tunnels in operation, and systematic rehabilitation training is performed after operation.