关节镜治疗膝关节前交叉韧带断裂体会

Arthroscopic Treatment of the Anterior Cruciate Ligament Rupture of the Knee Joint

目的:讨论使用关节镜技术微创治疗膝关节前交叉韧带断裂,部分合并半月板损伤的治疗体会。方法:本院从2022年1月~2022年10月收治膝关节前交叉韧带断裂患者29例,其中单纯膝关节前交叉韧带断裂患者24例,合并内侧副韧带断裂患者2例,合并外侧半月板损伤患者1例,合并内侧半月板损伤患者2例。采用随机抽签的方式分组,治疗组18例,对照组11例。治疗组以取自体股薄肌、半腱半膜肌肌腱,在关节镜下重建断裂的膝关节前交叉韧带,同时对于合并半月板损伤的患者,使用半月板缝合钉缝合固定,侧副韧带损伤未给与处理。对照组11例以石膏外固定保守治疗。结果:用Lyshlom评分评判治疗效果,治疗组患者治疗后评分明显高于对照组;治疗组的术后并发症明显低于对照组。结论:关节镜下自体肌腱重建术是微创治疗膝关节前交叉韧带断裂的一种创伤小、出血少、恢复快,感染率低的新型治疗手段。

Objective:To discuss the minimally invasive arthroscopic treatment of knee anterior cruciate ligament rupture,partially combined with meniscal injury.Methods:The hospital admitted 29 patients from January 2022 to October 2022,including 24 patients with simple knee anterior cruciate ligament rupture,2 patients with medial collateral ligament rupture,1 patient with lateral meniscus injury,and 2 patients with medial meniscus injury.Groups were grouped by random lottery,18 patients in the treatment group and 11 in the control group.In the treatment group,the ruptured anterior cruciate ligament of the knee was reconstructed from the tendon of the paraptominoris under the arthroscope.For patients with meniscus injury,the meniscus suture nail was used to suture and fixed.In the control group,11 patients were treated conservatively with an external cast fixation.Results:The treatment effect was judged by Lyshlom score,and the posttreatment score was significantly higher than the control group;The postoperative complications in the treatment group were significantly lower than the control group.Conclusion:Arthroscopic autologous tendon reconstruction is a minimally invasive treatment with little trauma,less bleeding,quick recovery and low infection rate.