关节镜下自体腘绳肌腱联合LARS人工韧带同期重建前、后交叉韧带临床疗效观察

A clinical observation of anterior and posterior cruciate ligament reconstruction under arthroscopy with hamstring tendon autograft combined with LARS artificial ligament

目的探讨关节镜下自体腘绳肌腱联合LARS人工韧带同期重建前、后交叉韧带的临床疗效。方法对采用关节镜下自体腘绳肌腱联合LARS人工韧带同期重建前、后交叉韧带的47例患者进行随访,使用Lysholm、IKDC评分对患者进行评估,评价临床效果。结果随访43例、失访4例,2例患者在术后3年出现前交叉韧带松弛,1例患者出现膝关节滑膜炎,1例患者术后6年再次外伤后交叉韧带断裂进行翻修。陈旧损伤患者术前Lysholm评分为(20.14±4.27)分,终末随访时为(93.36±5.21)分,较术前明显改善(P<0.05)。所有随访患者IKDC术前显著异常(D)43例,术后末次随访正常(A)36例、接近正常(B)5例、异常(C)2例。结论关节镜下自体腘绳肌腱联合LARS人工韧带同期重建前、后交叉韧带,中期疗效满意。

Objective To observe the clinical efficacy of anterior and posterior cruciate ligament reconstruction under arthroscopy with hamstring tendon autograft combined with LARS artificial ligament. Methods From June 2008 to December 2015,atotal of 47 patients underwent arthroscopicsimultaneous reconstruction of anterior and posterior cruciate ligament with hamstring tendon and LARS artificial ligament. Allpatients received MRI examination,while the X-rays were obtained pre-operation. The Lysholm,IKDC score was evaluated before and after operation. Results 43 patients were followed-up,four cases was lost and onepatient with synovitis.Twocaseshad anterior cruciate ligament laxity in threeyears after operation. One patient accepted revision ofposterior cruciate ligament reconstruction underwent injury again in 6 years after operation. The Lysholm score of patients with non acute injury was improved from20. 14 ± 4. 27 preoperatively to 93. 36 ± 5. 21 postoperatively. There were statistically significant differences before and after surgery（P〈0.05）. The preoperation IKDC evaluationwere D in all knees which improved to A（36 knees）,B（5 knees） and C（2 knees） postoperationly. Conclusion Anterior and posterior cruciate ligament reconstruction under arthroscopy with hamstring tendon autograft combined with LARS artificial ligamentprovides acceptable satisfying outcomes at mid-term follow-up.