前交叉韧带损伤外科治疗的10年回顾与反思

Retrospective Study and Consideration of Surgical Treatment of Anterior Cruciate Ligament Tear(ACL)for 10 years

目的 :分析不同手术方法治疗ACL损伤的疗效。方法 :采用Lysholm与Tegner膝关节综合功能评分及美国运动医学协会膝关节前方稳定性的诊断标准 ,对 1990 .1～ 2 0 0 0 .1手术治疗的 2 43例Ⅱ°～Ⅲ°ACL损伤病人进行了平均 3.9年的回顾调查。结果 :ACL修补 +半腱肌加强 ,半腱肌与股薄肌重建及关节镜下B PT B重建术后膝关节功能综合评分及前方稳定性明显优于断端缝合和钢丝拉出缝合 (P <0 .0 5 )。结论 :推荐ACL修补 +半腱肌加强 ;半腱肌—股薄肌重建和关节镜下B PT B重建作为ACLⅢ°损伤的首选手术。强调对膝关节复合韧带损伤的认识及术后系统康复锻炼的重要性。

Objective:To evaluate the results of various s ur gical treatments for Ⅱ°～Ⅲ°ACL injury.Method:Retrospective study was done fo r 243 operated patients from 1990.12 to 2000.1 through Lysholm and Tegner's comp rehensive score.Results:The results of ACL repair with augment,reconstruction wi th semitendinous and gracilis as well as arthroscopical reconstruction with B-P T -B is superior to that of simple end to end suture or pull out suture with stee l wire e ither by Lysholm score or Tegner's standard.Conclusion:It is recommended that th e operations such as ACL repair with augmentation,reconstruction with semitendi nous and gracilis as well as arthroscopical reconstruction with B-PT-B should be en first chosen for ACL injury.Meanwhile,the importance of recognition of combin ed ligament injured and rehabilitation is emphasized.