应用半腱肌、股薄肌和髌韧带在关节镜下重建前交叉韧带65例

Reconstruction of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament in 65 cases

目的 探讨应用髌韧带 (bone -patellartendon -bone,BTB)和半腱肌、股薄肌 (bone -ham string-bone ,BHB)在关节镜下修复前交叉韧带 (anteriorcruciateligament,ACL)损伤的临床疗效、手术要点及关节功能改善情况。 方法 在膝关节镜直视下 ,选用自体BTB和BHB行ACL重建手术 6 5例 ,其中BTB重建 30例 ,BHB重建 31例 ,股四头肌腱重建 4例。 结果 随访时间 1个月～ 3年 ,手术前Lachman和Pivotshift试验从阳性转为阴性 ,按日本骨科学会膝关节疗效评定标准 ,优 48例 ,良 7例 ,可10例。本组病人 2个月后均恢复原来日常活动 ,半年后恢复体育活动。结论应用BTB、BHB在关节镜下修复ACL损伤 ,术中等长点的选择是手术关键 。

Objective To observe the function recovery of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament. Methods A total of 65 cases, of which 30 cases were with BTB, 31 with BHB and 4 with quadriceps tendon were reconstructed under arthroscopy. Results The results showed that all cases attained excellent results. Lanchman test and pivot shift test changed from positive to negative with 1 month to 3 years of follow up. And all patients return to primary life activity in 2 months and sports in 6 months after ACL reconstruction. Conclusions The key to immediate rahabilitation and operative success is a firm fixation and a right select of isometric point.