关节镜下双股半腱肌重建膝关节前交叉韧带80例

Arthroscopic reconstruction of anterior cruciate ligaments in knee joints with double semitendinosus for 80 patients

目的 介绍关节镜下双股半腱肌闭合拉出钢板法重建前交叉韧带 (ACL)手术操作及其技巧。 方法 设计应用关节镜下双股半腱肌闭合拉出钢板法重建ACL ,对 80例患者手术操作经验进行总结。 结果 本组 80例完成关节镜下重建ACL手术 ,平均手术时间为 80min。术中出现穿导针弯曲、断裂 ,微型器械断裂 ,微型钢板骨隧道内受阻等情况。本组病例平均随访 16个月 ,除 2例术膝轻度胀痛外 ,其余患者无主诉症状。所有病例感觉膝部稳定 ,恢复原工作。Lysholm膝部评分 ,术前 (4 8± 12 )分 ,术后 (92± 4)分 (P <0 .0 1)。 结论 关节镜下双股半腱肌闭合微型钢板固定法重建ACL ,手术效果良好。临床实践中应掌握手术原则 。

Objective To introduce the surgical technique of arthroscopic reconstruction of anterior cruciate ligaments (ACL) with double semitendinosus and noninvasive steel miniplates. Methods Combined foreign experiences of arthroscopic reconstruction of ACL with clinical practice by ourselves on the surgery, the surgical technique for arthroscopic reconstruction of ACL with double semitendinosus was performed on 80 patients. This technique included femoral notch plasty, tibial and femoral tunnel placement, preparation of the graft and tenodesis with noninvasive steel miniplates. Results The surgical technique was successfully completed in all 80 patients, and the average time for the operation was 80 minutes. A few operative problems, such as bending or fracture of the guide pin, breaking of the mini instruments and blocking of the miniplates in the femoral or tibial tunnel, occurred during the surgery. Followed up averagely for 16 months, the patients had no complaint except 2 with mild distending pain in the knees. All the patients regained stable knees and returned to their original work. Lysholm knee scores were 48±12 preoperatively and 92±4 postoperatively( P <0.01 ). Conclusions The effect of arthroscopic reconstruction of ACL with double semitendinosus for treatment of ACL injuries is excellent.