带骨瓣的髌腱中1/3重建前交叉韧带

RECONSTRUCTION OF ANTERIOR CRUCIATE L IGAMENT BY FREE AUTOGRAFT OF MIDDL E ONE THIRD OF BONE- PATEL L AR TENDON- BONE COMPL EX

目的 评价带骨瓣的髌腱中 1/ 3重建前交叉韧带的效果。方法 1994年 4月～ 1996年 8月 ,共利用带骨瓣的自体髌腱中 1/ 3重建前交叉韧带 8例。结果 8例均获得 5个月～ 3年随访 ,平均 2 6个月。优 4例 ,良 3例 ,可 1例。术前 5例有明显膝关节不稳定感 ,术后均消失 ;术前 8例均存在 L anchman试验或 /和前抽屉试验阳性 ,术后有 1例呈前抽屉试验阳性 ;所有患者均能基本满足日常生活要求 ,1例仍残存膝关节疼痛。 3例术后存在不同程度的膝关节僵直 ,经过 CPM康复训练后膝关节屈伸活动度可达 0°～ 90°以上。结论 带骨瓣的髌腱中 1/ 3重建前交叉韧带是恢复膝关节功能的理想方法。

Objective To investigate the outcom e of anterior cruciate ligam ent (ACL ) by free autograft of m iddle one third of bone- patellar tendon- bone complex which was form ed by lower edge of patella,middle one third of patellar tendon,and tibial tubercle. Methods From April 1994to August 1996 ,ACL reconstruction by bone- patellar tendon- bone complex was performed in 8patients with ACL injury. Results All cases were followed up 5 m onths to 3years,averaged 2 6 months,excellent results were obtained in 4cases,better in 3cases and m od- erate in 1case. The L anchman test and/ or anterior drawer test were positive in 8cases preoperatively and only 1 case was positive postoperatively. Instability existed in 5 cases preoperatively were disappeared after operation. All patients could basically meet the demands of daily life. Conclusion Reconstruction of ACL by free autograft of middle one third of bone- patellar tendon- bone complex is an effective method for the restoration of stability in knee joint.