关节镜下Rigidfix和Intrafix系统固定自体腘绳肌重建前交叉韧带的临床疗效观察

The clinical effect of observation of arthroscopic anterior cruciate ligament reconstruction using Rigidfix and Intrafix system with quadruple-strand autograft hamstring tendons

目的观察关节镜下应用Rigidfix系统和Intrafix系统固定自体4股腘绳肌(4SHG)重建前交叉韧带的早期临床疗效。方法对关节镜下行前交叉韧带重建的25例,以自体4股腘绳肌腱作为移植物,股骨侧应用Rigidfix系统、胫骨侧应用Intrafix系统进行固定,在关节镜下行ACL重建并评价疗效。结果术后经3～14个月随访,所有病例临床症状消失,无严重并发症发生。24例膝关节活动度恢复正常,1例患者屈伸受限,2例膝关节有疼痛症状;前抽屉试验随访时均阴性,Lachman试验23例阴性,2例弱阳性;Lysholm评分从术前(38.27±7.03)分提高至术后的(89.06±5.09)分,IKDC评分22例正常,3例接近正常,差异有统计学意义(P<0.01)。结论关节镜下应用Rigidfix系统与Intrafix系统固定自体4股腘绳肌肌腱重建ACL临床效果满意,具有手术操作简单、创伤小、固定牢靠、术后恢复快等优点。

Objective To study the early clinical curative effect of arthroscopic reconstruction of anterior cruciate ligament using Rigidfix and Intrafix pin system with quadruple - strand hamstring tendons. Methods All medical records which were reconstruction of anterior cruciate ligament under arthroscope. Meet the requirements of 25 cases were selected, which were reconstructed arthroscopically with four strands of hamstring tendons, and the grafts were fixed with Rigidfix and Intrafix system. Patients were treated by systematic re- habilitation therapy and relevant complications were managed post - operatively. The patients were followed up for 3 - 14 months, and the patients subjective symptom was asked, the knee range of motion was examined. And anterior drawer test, Lachman test were per- formed to evaluate clinical result according to Lysholm rating and IKDC. Results 25 cases of postoperative were followed up for 3 - 14months, All clinical symptoms disappeared eventually and there was no serious complications. 24 cases of knee joint after operation of activities were normal, one case of knee joint flexion and stretching was limited, and two cases with anterior knee had pain symptoms.When patients were followed up, Anterior drawer test ： negative all cases, a Lachman test ： negative 23 cases, weak - positive 2 cases; The Lysholm score increased from （38.27 ± 7.03 ） to （89.06 ± 5.09）, IKDC scoring 22 cases were normal, 3 cases were almost nor- mal, and the difference was significant （P 〈 0.01 ）. Conclusion It has satisfactory outcome for reconstruction of anterior cruciate liga- ment using Rigidfix and Intrafix system with quadruple - strand autograft hamstring tendons. It has advantages of simple operation, firm fixation and quick postoperative recovery.