膝关节前交叉韧带(ACL)损伤的临床诊治分析

目的：探讨膝关节前交叉韧带损伤的临床诊断和相应的治疗措施，并分析其优势。方法：收治膝关节不稳定患者46例f47膝），经前抽屉试验，Lachman试验、轴移试验、磁共振检查和关节镜检查，确诊膝关节前交叉韧带损伤．分为完全损伤和不完全损伤，行关节镜下自体肌腱（股薄肌肌腱和半腱肌肌腱）重建术。结果：所有患者均获得随访，随访时间6～24个月，平均12．5个月，术后早期未见严重并发症，Lysholm膝关节功能评分86．78±7．23分，平均9067±8．57．较手术前4714±8．20分，平均52．14±4．25分有明显改进。结论：膝关节前交叉韧带损伤，表现为膝关节不稳定，关节镜下双股单束或4股双柬重建前交叉韧带，手术损伤小，手术后关节功能恢复满意，是较为理想的一种治疗方法。

Objective：To explore and anal- yse clinic diagnosis and treatment of anteri- or enleiate ligament injury.Methods：From June 2004 to May 2012,46 patients （46 knees） with the instability of knee were treated surgically in our hospital;through clinical examination,eg：anterior drawer test, Laehman test,pivot shift tset,MRI（magnetic resonance imaging）exmanation and arthros- copy exmanation,all the patients had made a final diagnosis.These injuries are named complete anterior cruciate ligament tears and partial anterior cruciate ligament tears. Concomitant arthroscopic single bundl ACL reconstruction and two bundls ACL recon- struction with antogenous tendons are rec- ommended alternatirely with advantages of mini-invasian and reliable outcome.Results： Of all the cases were followed up for 6-24 months （mean 12 months）.No severe compl- cations occurred after operation in the 46 patients.Lysholm score was remarkable im- proved from 47.14 v 8.20 mean52.14 ±4.25 preoperatively to 86.78 ±7.23 mean90.67 ±8.57 at follow up（P〈0.0001）.Conclusion： The instability of knee is complainted by the patients with anterior cruciate ligament tears.The damaged ACLs were reconstructed with aatogenous tendons nuder arthrascopy. The advantages of arthroscopy operation are minimum injury.h is a safe and effective treatment for the patients with anterior cru- ciate ligament injury,less complications.