关节镜下四股半腱肌肌腱重建前交叉韧带

Arthroscopic reconstruction of anterior cruciate ligament with quadrupled semitendinosus tendon

目的探讨关节镜下利用四股半腱肌肌腱对陈旧性前交叉韧带(ACL)损伤的患者进行单隧道重建的临床疗效。方法 20例陈旧性单侧前交叉韧带损伤患者进行手术治疗,手术均由同一治疗小组行关节镜下单隧道重建。术前及术后对患者膝关节的活动度、稳定性、日常生活能力、自觉症状、肌肉功能进行对比随访。结果术后4周时所有患者膝关节活动度均接近正常,术后2年随访均无明显过伸及屈曲畸形,Lysholm评分平均分为96.5分;大腿肌肉有轻度萎缩,但不影响关节功能;所有患者向前变速及后退跑时未见明显跛行;未出现隧道扩大、严重骨性关节炎、半月板损伤等并发症。结论关节镜下四股半腱肌肌腱结合微型缝线钢板、钮扣固定单隧道重建前交叉韧带是治疗陈旧性前交叉韧带的可靠术式,能够很好的恢复膝关节的功能。

Objective To investigate the outcomes of arthroscopic reconstruction of anterior cruciate ligament（ACL）with quadrupled semitendinosus tendon.Methods Arthroscopic reconstruction of ACL with quadrupled semitendinosus tendon in 20 cases with chronic ACL ruptures.The range of motion and stability of the knee,knee function in daily activity,running ability,subjective symptom and muscle function were evaluated and compared before and after surgery.Results The motion ranges of injuried knees were regained in all cases four weeks after operation.Deformities of hyperextension and flexion were not found in 2 years after operation.The average Lysholm knee score was 96.5.The muscle of upper leg had a little analosis,but did not affect function of the knee.Lameness was not found in all patients during running forward or backward with different speeds.There were no other complications of enlargement of tunnel,serious ostarthritis,meniscus injury.Conclusion Single-tunnel arthroscopic reconstruction of ACL with quadrupled semitendinosus tendon,suture plate and button fixation is a reliable way for treating the obsolete ACL injury and restoring function of the knee.