超高分子聚乙烯套栓闭合韧带固定术的临床研究

Clinical Study on A Newly Designed Tenodesis with Polymolecular Polyethlene Fastener

目的 :设计、应用超高分子聚乙烯套栓闭合韧带固定术 ,提出临床使用价值。方法 :采用新型研制的超高分子聚乙烯套栓闭合韧带固定法 ,修复、重建 89例膝关节韧带损伤 ,其中重建前交叉韧带 (ACL) 74例 ,后交叉韧带 (PCL) 13例 ,外侧副韧带 2例。韧带重建术后第 2日由专科治疗师实施康复计划。结果 :89例患者均一次固定成功。 2例套栓、3例移植腱在骨隧道内牵拉受阻 ,套栓退出后清理骨隧道 ,重新牵拉套栓经骨隧道顺利通过 ;1例套栓在骨隧道内嵌顿 ,不能退出 ,镜下取出套栓 ,重新缝合移植、修复的韧带 ,闭合固定成功。本组病例平均随访 19个月 (6个月～ 4 9个月 ) ,7例关节内韧带重建术后较对侧稍松动 ,但较术前功能明显改善 ,2例膝部劳累后胀痛 ,3例关节屈曲受限 2 0度 ,其余病例关节稳定 ,关节功能正常。Lysholm关节功能评分 ,术前 5 6± 8,术后 89± 5 (P <0 .0 1)。结论 :超高分子聚乙烯套栓闭合韧带固定法 ,具有操作简便 ,安全可靠 ,无副作用 ,明显缩短手术时间等特点。

Aim To investigate the clinical importance of a newly designed tenodesis with polymolecular polyethlene fastener. Methods Eighty-nine patients with knee ligaments injuries were reconstructed with the technique of newly designed tenodesis. Rehabilitation program started under the instruction of the therapist from the next day of the surgery.Results The tenodesis on all patients in our study were successful. The fasteners in two patients and the transplants in three patients were blocked in the bone tunnel during the operation. One fastener was taken out from the bone tunnel under arthroscopy. The patients were followed up for 19 months averagely (from 6 months to 49 months), most of them showed a stable knee without complain, except two patients feel uncomfortable after vigorous activities; seven patients show little laxity in anterior drawer test (ADT) or posterior drawer test (PDT) and three patients had 20-degree limitation of knee flexion. Lysholm scale score were 56±8 and 89±5 before and after operation, respectively ( P < 0 01). Conclusion This newly designed tenodesis with polymolecular polyethlene fastener was proved to be easy to perform and safe without side effects.