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例滑膜炎患者,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由术前显著异常(D)43例,到术后末次随访正常(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 A total of 47 patients underwent the arthroscopic simultaneous reconstruction of anterior and posterior cruciate ligament with hamstring tendon and LARS artificial ligament. All the patients were received MRI examination,while the X-rays were obtained before the operation. The Lysholm and IKDC score were evaluated before and after the operation. Results 43 patients were followed-up,4 cases were lost and 1 patients with synovitis. 2 case had anterior cruciate ligament laxity in 3 years after operation. 1 patient accepted revision of posterior cruciate ligament reconstruction undwent injury again in 6 years after operation. The Lysholm score of patients with scaral fracture were improved from 20. 14 ± 4. 27（ preoperation） to 93. 36 ± 5. 21（ postoperation）. There were statistically significant differences before and after surgery（ P〈0. 05）. The preoperation IKDC evalution were 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 ligament provides the satisfactory effect at the mid-term follow-up.