异体跟腱双束重建后交叉韧带损伤的疗效观察

Observation on the Efficacy of Allogeneic Achilles Tendon Double-bundle Reconstruction of PCL Injury

【目的】探讨双束重建后交叉韧带（PCL）的手术方式及临床疗效。【方法】回顾性分析2007年3月至2010年2月单纯PCL损伤行关节镜下异体跟腱股骨侧双隧道，胫骨侧单隧道重建PCL的患者56例。术后随访时行三维CT、MRI检查影像学变化，KT-2000测量双侧膝关节膝关节前后向松弛差异，并按照Ly—sholm、Tegner、改良Larson膝关节评分标准进行疗效评价。【结果156例获得随访病例中，随访时间37．3（24～56）个月，除1例因排斥反应关节肿胀、发热，行关节镜冲洗后好转，2例后抽屉实验阳性，其余患者随访时移植物位置及关节功能良好。患者术前、术后Lysholm、Tegner、改良Larson膝关节评分及KT2000测量值比较均有统计学意义（P〈0．05）。【结论】双柬重建PCL符合解剖生理结构，可很好的恢复膝关节功能，术后疗效满意。

[Objective] To explore the surgical approach and clinical efficacy of double bundles for the recon- struction of posterior cruciate ligament（PCL）. [Methods]A total of 56 patients with simple PCL injury undergoing arthroscopic allogeneic achilles tendon for PCL reconstruction via twin femoral tunnel and single tibial tunnel from March 2007 to Feb. 2010 were analyzed retrospectively. During the follow up after the operation, 3-dimensional CT and MRI were performed for the image examination. KT-2000 was used to measure the difference in relaxation between bilateral knee joints. According to Lysholm, Tegner and modified Larson knee joint score criteria, the efficacy was assessed. [Results] All 56 patients were followed up for 24-56 months（mean 37.3 months）. Except one patient with joint swelling and fever due to rejection reaction was improved by arthroscopic irrigation and 2 patients were pos- terior drawer test（q-）, other patients had good location of the good location of the grafts and joint function. There were significant differences in Lysholm, Tegner, modified Larson knee joint score and KT-2000 value between before and after the operation（ P〈0.05）. [Conclusion] Double-bundle reconstruction of PCL accords with anatomic physiological structure, and can restore knee joint function well and obtain satisfactory postoperative results.