腘绳肌腱结合双固定技术重建前交叉韧带

Application of femoral tunnel and tibia tunnel with double fixation technique in anterior cruciate ligament reconstruction with quadruple hamstring tendon autograft

目的探讨采用腘绳肌腱股骨端胫骨端双固定技术重建前交叉韧带(ACL)的可行性及近期疗效。方法对25例ACL损伤行关节镜下ACL重建术,采用笔者自行设计双监视法解剖等长重建技术建立股骨胫骨隧道。移植物股骨端用Endobutton钢板和Rigidfix固定,胫骨端用Bio-Intrafix和Stample门形加压钉固定。结果本组获随访12～18(13.76±1.61)个月,未发现滑膜炎、韧带断裂、活动度明显障碍等并发症。根据Lysholm膝关节功能评分,术前评分:20～48(31.32±8.71)分;术后1年评分:90～98(94.96±2.56)分(t=37.69,P<0.01)。结论在腘绳肌腱重建ACL中应用股骨端胫骨端双固定技术具有手术操作简便,固定牢固,效果可靠的优点,值得推广。

Objective To study the feasibility and short-term effects of femoral tunnel and tibia tunnel with double fixation technique in anterior cruciate ligament（ACL） reconstruction with quadruple hamstring tendon autograft.Methods Arthroscopic ACL reconstruction was carried out in 25 patients with ACL injuries by using the quadruple hamstring tendon autograft.All patients used two-stakeout anatomy isometric technique to prepare method of the bone tunnels of the femur and the tibia.Quadruple hamstring tendon were fixed with femoral Endobutton plate and Rigidfix fixation,tibia Bio-Intrafix and Stample fixation.Results All patients were followed up for 12 to 18（13.76±1.61） months.No postoperative complications such as synovitis and ligament rupture and movement restriction occurred.The Lysholm scores improved from a preoperative score of 20 to 48（31.32±8.71） to 90 to 98（94.96±2.56） at follow-up.There were significant difference in the Lysholm scores between preoperative group and postoperative group（t =37.69,P 0.01）.Conclusion Femoral tunnel and tibia tunnel with double fixation technique can be simple,effective,useful,and reproducible and gives a satisfactory short-term results in arthroscopic reconstruction with quadruple hamstring tendon autograft.