关节镜下LARS人工韧带重建前后交叉韧带及有限切开增强内侧副韧带

Under Arthroscope Around LARS Artificial Ligament Reconstruction Overlapping Ligament And Limited Incision Enhancement Inside Ligamentum Accessorium

目的探讨应用LARS人工韧带关节镜下重建前后交叉韧带,对同时合并内侧副韧带损伤的病例可利用残余的LARS人工韧带进行内侧副韧带增强的手术方法及临床疗效。方法2008年7月起应用LARS人工韧带治疗膝关节前交叉韧带断裂、后交叉韧带断裂及前后交叉韧带加内侧副韧带同时断裂患者共8例。术前膝关节Lysholm评分平均26.1分。均在关节镜下进行交叉韧带LARS人工韧带重建,其中3例同时有限切开重建内侧副韧带。结果术后随访2～10个月,平均3.8个月。其中1例术后出现患膝肿胀疼痛,经抗炎镇痛治疗后好转,其余病例术后无感染、韧带松动、自发断裂等并发症,术后无伸膝受限,屈膝活动度110～120°。终末随访时Lysholm膝关节功能评分为平均93.6分。结论应用LARS人工韧带关节镜下重建前后交叉韧带,同时重建内侧副韧带可达到膝关节解剖结构重建,有即刻稳定性好、手术创伤小等优点。

Objective To evaluate the LARS artificial ligament under arthroscope to reconstruct before and after, to simultaneously merge case of the inside ligamentum accessorium damages to be possible to use the remaining LARS artificial ligament to carry on the surgery method and the clinical curative effect which the inside ligamentum accessorium strengthens. Method Since July 2008 for 8 cases to apply of LARS artificial ligament to treat for 1 case the front and for 2 cases the back overlapping ligament break of knee joint and for 3 cases the fore-and-aft overlapping ligament with the inside ligamentum accessorium simultaneously break, for 2 cases the back overlapping ligament dated break. Male 7 cases, female 1 case, age 20 to 60 years old, average age 40.25 years old. Before treatment knee joint Lysholm grading average 26.1 points. Carries on under arthroscope the overlapping ligament and LARS artificial ligament reconstruction, three examples of them at the same time limited incision reconstruction inside ligamentum accessorium. Results After finally the technique makes a follow-up visit for 2-10 months, the average 3.8 months.1 case of this group has the occurrence of the knee joint infects, after the antiinflammatory treatment this case reported improvement. Others of this group after the treatment does not have the phenomenen to infection, the ligament spontaneous break and Loosening ,the acute synovitis complication, and not has the occurrences of the knee joint infects, not extends the knee to receive limits, bows the activity 110-120°.When at the end of end revisit Lysholm knee joint function grading for average 93.6 points. Conclusion Around the conclusion applies under arthroscope the LARS artificial ligament to reconstruct the overlapping ligament, simultaneously reconstructs the inside ligamentum accessofium to be possible to achieve the reconstruction of knee joint dissection structure, has the merits instantly the stability well, the surgery wound small and so on, but the arthroscope technology is high, the expense is slightly high.