关节镜下半腱肌腱双束双隧法重建后交叉韧带的效果观察

The effect of posterior cruciate ligament using the method of the semitendinosus tendon double tunnel reconstruction under arthroscopic

目的探讨应用双股折叠半腱肌腱在关节镜下重建后交叉韧带(Posterior cruciate liga-ment)的方法及疗效。方法 2000年8月至2010年7月共收治26例PCL损伤患者,使用开口螺旋肌腱剥离器剥离半腱肌腱,在肌腱肌腹交接处切断,保留肌腱远端附着点,纵行剖为两股,剖面对折缝合。于股骨内髁PCL附着点处分别钻取前后两隧道,与胫后内外两隧道引出的重建韧带形成交叉,游离端使用生物界面螺钉固定,术后早期功能锻炼。结果术后平均随访23个月,Lachman试验术前22例阳性,术后1例阳性;轴移试验术前18例阳性,术后均消失;Lysholm膝关节功能评分:术前平均66.9分,术后平均94.3分;IKDC术后评分:A级16例,B级9例,C级1例。结论使用双隧道双股折叠半腱肌于关节镜下重建PCL能接近原有的解剖学结构,具有操作简单,重建韧带强度大,稳定性强,并发症少,能早期活动等优点。

Objective To explore the method and effect of the semitendinosus tendon double tunnel reconstruction under arthroscopic.Methods Form August 2000 to July 2010,26 patients with PCL were treated.The clinician used the open spiral stripping machine,cuted the joint of the tendon and the venter,leaved the tendon remote attachment point,devided into two parts,and the profile were folded suture.Drilled two tunnels at the PCL attachment point inside the thighbone,and performed the functional exercise in early stage after operation.Results After operation,the patients were followed-up 23 months.Before operation,22 cases were positive in the Lachman trial,1 case was positive after operation.Before operation,18 cases were positive in the remove trial,all of them had disappeared after operation.Before operation,the evaluation of the function of the lysholm knee joint was 66.9 on average,after operation was 94.6 on average.There were 16 cases of grade A,9 cases of grade B,1 case of grade C.Conclusion The method close to anatomical structure,it has the advantages of easily operating,ligament intensity,strong stability,less complication and earlier movable.