关节镜下同种异体肌腱重建前交叉韧带的临床观察

Clinical observation of reconstruction of anterior cruciate ligament with allogeneic tendon under arthroscopy

目的探讨同种异体肌腱在关节镜下重建前交叉韧带中的临床应用及短期疗效。方法关节镜下应用经由内向外（通过胫骨隧道）方法行股骨隧道定位,股骨隧道采用悬吊固定,胫骨隧道固定应用可吸收界面螺钉同种异体肌腱重建前交叉韧带。术后佩戴可调式膝关节固定支具3个月行康复训练。术前和术后分别采用Lachman试验评估膝关节的稳定性。结果所有患者术前Lachman试验存在阳性体征,术后仅1例呈弱阳性。术前Lysholm评分为34~51分,平均47.5分;术后半年Lysholm评分为71~95分,平均87.3分。结论关节镜下同种异体肌腱用于重建单纯性前交叉韧带损伤,具有损伤小、恢复快、固定可靠、功能锻炼时间早、早期疗效好的优点,然而术后系统的康复功能训练不可忽视,中远期疗效仍有待观察。

Objective To investigate the clinical application and short-term effects on reconstruction of simply injured anterior cruciate ligament with allogeneic tendon under arthroscopy.Methods The method of inside-out（from tibial tunel） was used to locate the femoral tunnel,the femoral tunnel was fixed with suspension button,and the tibial tunnel was fixed with bio-interference screw.Rehabilitation train was processed for 3 months with the adjustable knee external frame support.Lachman test were used to assess the stability of the knee before and after operation.Results The Lachman test results were positive in all cases before operation,but only l case had slight positive Lachman test after operation.The average of Lysholm knee scores were 47.5 points（34 to 51 points） before operation,and 87.3 points（71 to 95 points） after surgery.Conclusion Reconstruction of simply injured anterior cruciate ligament with allogeneic tendon under arthroscopy has the advantages of minimal truma,fast recovery,reliable fixation,allowance of early exercises and good short-term efficacy.However,postoperative rehabilitation should be regular and systematic,and long-term results remains to be confirmed.