联合应用半腱肌腱与股薄肌腱越顶重建前交叉韧带

Anterior Cruciate Ligament Reconstruction Using Semitendinosus and Gracilis Tendons Over the Top Graft

目的探讨联合应用半腱肌腱与股薄肌腱越顶重建前交叉韧带的外科技术和疗效。方法自１９９３年１月～１９９６年１２月，１６例前交叉韧带撕裂伤患者接受了联合半腱肌腱与股薄肌腱越顶重建手术治疗。其中男１４例，女２例。随访时间１３～３６个月，平均２０．３个月。结果按膝关节疗效评定标准，优６例（３７．５％），良８例（５０．０％），可２例（１２．５％），优良率８７．５％。大部分患者在步行和日常生活能力方面均有明显改善。结论该术式疗效满意，其成功的关键在于：（１）手术中越顶固定时，应维持移植物适当的张力；（２）损伤的侧副韧带必须及时修复；（３）术后正确的康复训练指导。

Objective To evaluate the surgical technique and the results of anterior cruciate liga- ment reconstruction using semitendinosus and gracilis tendons over-the-top repair. Methods 16 patientswere operated upon. The mean period of follow-up was 20. 3 months. Results Each patient was evaluatedusing the knee functional scales, 6 patients (37. 5% ) were clinically rated as excellent, 8 cases(50% ) asgood and 2 cases(12. 5% ) as fair results, there was no poor result. POst-operatively most of the patients hadapparent improvement in function of walking and daily activities. Conclusion The semitendinosus andgracilis tendons over-the-top repair is a sound and effective method of treating anterior cruciate ligament insufficiency. The key points of success of this operation are: I ) maintaining appropriate tension during fixation of both of the grafted tendons, 2) the lateral collateral ligament if injured, must be repaired, 3) in additionPOstoperative functional exercise play a very important role in the outcome.