关节镜下一期人工韧带治疗膝关节多发韧带损伤

One-stage Arthroscopic Reconstruction for Multiple Ligament Injuries of Knees With LARS Artificial Ligaments

目的探讨一期关节镜下应用人工韧带治疗膝关节多发韧带损伤的疗效。方法回顾性分析2014年1～12月膝关节多发韧带损伤(SchenckⅢ型)19例资料。手术距受伤时间6～18 d,平均11.6 d。均一期在关节镜下应用LARS人工韧带(Ligament Advanced Reinforcement System)重建前和(或)后交叉韧带。采用膝关节Lysholm评分、Tegner评分评定疗效。结果 19例术后随访22～28个月,平均24.5月。无膝关节感染、韧带断裂、韧带松弛等。末次随访时,膝关节Lysholm评分(85.6±2.2)分,Tegner评分(5.4±1.1)分,均较术前(33.2±2.3)分及(2.4±0.9)分明显提高(配对t检验,t=-22.422、-24.312,P均=0.000)。结论应用LARS人工韧带治疗膝关节多发韧带损伤疗效满意。

Objective To investigate the effect of one-stage arthroscopic reconstruction for multiple ligament injury of knees with Ligament Advanced Reinforcement System（ LARS） artificial ligaments. Methods Nineteen patients who suffered from multiple ligament injury of knees（ Schenck Ⅲ） were admitted to our hospital from January 2014 to December 2014. All the patients received operation within 6-18 d（ mean,11. 6 d）. Under arthroscopy,anterior cruciate ligament（ ACL） and/or posterior cruciate ligament（ PCL） were reconstructed with LARS artificial ligaments simultaneously. Preoperative and postoperative Lysholm function score and Tegner score were used to evaluate effects. Results All the 19 patients were followed up for 22-28 months with an average of 24. 5 months,which showed no infection,ligament rupture,ligament loosening,or other postoperative complications. The Lysholm scores were remarkably increased from 33. 2 ± 2. 3 preoperatively to 85. 6 ± 2. 2 at the latest follow-up,and the Tegner scores were increased from 2. 4 ± 0. 9 preoperatively to 5. 4 ± 1. 1 at the latest follow-up,the difference having statistical significances（ t =-22. 422,P =0. 000; t =-24. 312,P = 0. 000）. Conclusion Reconstruction of ACL and PCL by LARS artificial ligament is a safe and effective method.