关节镜下膝关节前交叉韧带重建术45例报告

REPORT ON ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN 45 CASES

目的 :总结 45例关节镜下前交叉韧带重建的经验体会。方法 :关节镜下移植中 1 / 3骨 -髌韧带 -骨组织重建膝关节前交叉韧带 ,用于治疗前交叉韧带损伤后关节不稳定。结果 :所有患者平均随访 1 5个月。Lysholm评分由术前 57分提高到 93分。所有患膝术前前抽屉试验及Lachman试验均阳性 ,术后 2例前抽屉试验阳性 ,3例Lachman试验弱阳性。所有患者主观评价膝关节功能明显增进 ,对治疗效果满意。结论 :在关节镜直视下 ,能准确定位前交叉韧带解剖止点 ,钻制骨隧道 ,植入移植组织。采用界面挤压螺钉固定移植物 ,不需外固定。该技术具有不切开关节囊 ,损伤小 。

Objective:To summarize the experience in 45 cases of arthroscopic anterior cruciate ligament reconstruction.Methods:To transplant middle one third bone-patellar tendon-bone graft under arthroscope, treating unstable knee after anterior cruciate ligament injury.Results:All patients got average follow-up of 15 months. The Lysholm score rise from average 57 point preoperatively to average 93 point postoperatively.All patients had positive anterior drawer test and lachman test preoperatively, only 2 cases had positive anterior drawer test and 3 cases slight positive lachman test at the last follow-up time. In the subjective evaluation, all patients conside that their knee's function is greatly improved and were satisfied with the results.Conclusion:Under arthroscope, one can accuratelly localize the anatomic ACL insertion, drill holes and transplant tissue grafts. There is no need for external fixation as using interface scews. This tecnique has the advantages of no capsule incision, less trauma and lower adherence incidence.