LARS中空韧带复合自体腘绳肌腱重建前交叉韧带手术技术

Arthroscopic reconstruction of anterior cruciate ligament with autologous quadrupled hamstring tendon composited with cannulated LARS artificial ligament

[目的]介绍LARS中空韧带复合自体腘绳肌腱重建前交叉韧带的手术技术和初步临床疗效。[方法]2018年8月~2019年1月,本院手术治疗前交叉韧带损伤患者18例,其中男11例,女7例,平均年龄(34.30±3.80)岁。切取半腱肌腱和股薄肌腱,折成四股编织缝合,再将其置入中空LARS人工韧带内编织缝合,制备直径8~9 mm的移植物,解剖位单束重建前交叉韧带。采用VAS评分、Lachman试验、Lysholm评分及IKDC评分评价临床效果。[结果] 18例均获随访,平均随访(4.20±1.90)个月。术后VAS评分、膝关节Lysholm评分及IKDC评分均较术前显著改善,临床结果评定优16例,良2例。[结论] LARS中空韧带联合自体腘绳肌腱重建前交叉韧带可快速恢复膝关节稳定性与功能,能较快地使患者重返生活及运动。

[Objective] To introduce the surgical technique of arthroscopic reconstruction of anterior cruciate ligament with autologous quadrupled hamstring tendon composited with cannulated LARS artificial ligament and its primary clinical outcomes. [Methods] Between April 2018 and January 2019, 18 patients, including 11 males and 7 females with an average age of(34.30±3.80) years, were surgically treated by arthroscopic reconstruction with autologous quadrupled hamstring tendon composited with cannulated LARS artificial ligament for anterior cruciate ligament tear in our department. After the semitendinosus and gracilis tendons were harvested, the tendons were trimmed, folded into 4 strands and weave sutured. After that, the tendon graft was inserted into a cannulated LARS ligament, and sutured to form a composited graft of 8~9 mm in diameters. Subsequently, the torn anterior cruciate ligament was replaced by arthroscopic single bundle reconstruction at anatomic position with the composited graft. The VAS score, Lachmantest, Lysholm and IKDC scores were applied for evaluation of the clinical consequences. [Results] All patients were followed up for(4.20±1.90) months on average. The VAS, Lysholm and IKDC scores at the latest follow-up after operation significantly improved compared with those before operation(P<0.05). The clinical outcomes were graded as excellent in 16 and good in 2 patients. [Conclusion] This autologous quadrupled hamstring tendon composited with cannulated LARS artificial ligament takes benefits of both autologous and artificial graft for anterior cruciate ligament reconstruction, and more greatly facilitates the enhanced postoperative rehabilitation to allow early return to daily life and sports.