经前内侧入路单束四股腘绳肌腱重建前交叉韧带的临床分析

Clinical analysis of transplantation of single- bundle four- strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction

目的：探讨关节镜下经前内侧入路（ anteromedial,AM）行自体单束四股腘绳肌腱重建前交叉韧带（ anterior cruciate ligament, ACL）的临床疗效。方法：对收治的20例 ACL 断裂患者采用 AM 法行自体单束四股腘绳肌腱重建前交叉韧带,术后指导患者行功能锻炼。采取 Lysholm 评分标准对患者术前、术后6个月、12个月膝关节主观功能进行评分。结果：随访20例患者,随访时间12~18个月,平均14个月。患者术前 Lysholm 评分（53.5±6.9）,术后6个月 Lysholm 评分为（88.4±5.2）,术后12个月 Lysholm 评分为（91.6±4.2）,差异有统计学意义（P〈0.01）。结论：关节镜下 AM 法行自体单束四股腘绳肌腱重建前交叉韧带是维持膝关节稳定、恢复膝关节功能的重要方法,值得临床研究推广。

Objective：To assess clinical effects of arthroscopic reconstruction of anterior cruciate ligament （ACL） using single-bundle four-strand hamstring tendon via anteromedial approach. Methods：20 cases of ACL fracture patients were treated with the single-bundle four-strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction, and guided them with functional exercises after operation. Lysholm score standard was used for the subjective function of the knee： before the operation, 6 months and 12 months after the operation. Results： The 20 cases were followed up for 12-18 months with an average of 14 months. The Lysholm score was improved from （53. 5±6. 9） points before the operation to （88. 4±5. 2） points （6 months after the operation） and （91. 6±4. 2） points （12 months after the operation）, and the differences were statistically significant （P〈0. 01）. Conclusions：The arthroscopic reconstruction of anterior cruciate ligament using the single-bundle four-strand hamstring tendon via anteromedial ap-proach is an important method to maintain the stability of knee and recover the knee function, and worthy of strongly clinical research and extension.