可吸收挤压螺钉关节镜下置入固定自体腘绳肌重建前交叉韧带

Absorbable screw fixation with autologous hamstring for reconstruction of anterior cruciate ligament under arthroscopy

背景:治疗膝关节前交叉韧带损伤过程中,关节镜下进行重建修复是一种常用的手段,其中肌腱的固定是一项重要内容。目的:探讨关节镜下可吸收挤压螺钉置入固定自体腘绳肌前交叉韧带重建的临床效果。方法:纳入47例行前交叉韧带重建的患者,其中男27例,女20例,年龄18-48岁,均实施关节镜下可吸收挤压螺钉置入固定自体腘绳肌重建治疗。治疗后随访12个月,治疗前和治疗后1,3,6,12个月,分别对患者进行Lysholm、Tegner、IKDC评分,治疗后12个月对患者进行X射线正侧位片及MRI复查,并记录不良反应发生情况。结果与结论:(1)术后患者膝关节不稳症状、关节痛均消失,未出现"打软腿"现象,行走步态恢复至正常水平,伤口均一期愈合,治疗后3,6,12个月的Lysholm、Tegner、IKDC评分均明显高于治疗前(P<0.05);均未出现切口感染和神经损伤、深静脉血栓等,1例患者出现膝关节积血,其余患者治疗过程中均未出现任何不良事件;(2)治疗后12个月影像学检查显示,患者均未出现骨隧道扩大等现象,关节间隙未出现明显变化;(3)结果表明:可吸收挤压螺钉置入固定自体腘绳肌重建前交叉韧带创伤小、效果好,可显著改善患者肢体功能。

BACKGROUND： Arthroscopic reconstruction is a common method in the treatment of anterior cruciate ligament injury, in which tendon fixation is an important part. OBJECTIVE： To investigate the clinical effect of absorbable screw fixation with autologous hamstring for anterior cruciate ligament reconstruction under arthroscopy. METHODS： Totally 47 cases of anterior cruciate ligament reconstruction were included, containing 27 male patients and 20 female patients, aged from 18-48 years old, and all patients underwent the absorbable screw fixation with autologous hamstring implantation. After 12-month follow-up, patients underwent Lysholm, Tegner, and IKDC scoring before treatment and after 1, 3, 6 and 12 months, respectively. Additionally, anterioposterior lateral X-ray and MRI reexamination were performed, and adverse reactions were recorded at 12 months after treatment. RESULTS AND CONCLUSION： Postoperative knee instability symptoms such as ＂weak legs＂ walking gait recovered to normal levels, and the wound all reached the primary healing. Moreover, the Lysholm, Tegner and IKDC scores at 3, 6 and 12 months after treatment were significantly higher than those before treatment （P 〈 0.05）. There were no incision infection, nerve injury, deep vein thrombosis and other adverse events except hemarthrosis of the knee joint in one case. After 12 months of treatment, the imaging examinations showed that there was no enlargement of the bone tunnel, and no significant change in the joint space. In conclusion, the absorbable screw fixation with autologous hamstring for the reconstruction of anterior cross ligament has good fixing effect and little trauma, and significantly improves the extremity function of patients.