前交叉韧带翻修重建的临床研究.docVIP

前交叉韧带翻修重建的临床研究 马勇 敖英芳 崔国庆 余家阔 肖健 龚熹 闫辉 杨渝平 程序 谢兴 【摘要】 目的 探讨前交叉韧带（Anterior Cruciate Ligament, ACL）翻修重建的处理原则及影响手术效果的因素。方法 2001年11月～2006年7月收治ACL翻修的病例12人；其中男性9例，女性3例，年龄16～39岁，平均28岁，均在关节镜下行探查与翻修手术。结合上述病例分析翻修的适应症、术中处理以及临床效果。结果 本组病例翻修术前患膝关节有明显不稳症状。2例因骨道骨质严重缺损行一期植骨术。其余10例一期行ACL翻修手术，重建移植物用同侧腘绳肌腱（STG）4例，对侧STG 4例，同侧骨-髌腱-骨（B-PT-B）1例，髂胫束1例。ACL翻修术后KT-2000检查平均差值在膝关节屈曲90°位和30°位分别为1.6mm和3.1mm；术后IKDC、Lysholm及Tegner评分平均分别为72.8、78.3、4.9，较术前有明显改善。结论 ACL翻修重建后患膝的主观功能和客观稳定性可获明显改善；但因原有手术不足及再次手术等多种因素作用，会影响最终临床效果。 【关键词】 前交叉韧带；重建；翻修；关节镜 Revision anterior cruciate ligament reconstruction and clinical research. MA Yong, AO Ying-fang, CUI Guo-qing, YU Jia-kuo, XIAO Jian, GONG Xi, YAN Hui, YANG Yu-ping, CHENG XU, XIE Xing . Institute of Sports Medicine, Third Hospital of Peking University, Beijing 100083 , China Corresponding author：AO Ying-fang， Email：yingfang. ao @vip. sina. com 【Abstract】 Objective To analyze the management principle of ACL revision reconstruction and the factors contributing to its result. Methods 12 patients received ACL revision reconstructions from November 2001 to July 2006 were studied retrospectively. We analyze the indication of the operation, the management during the procedure and the clinical results according to the data above. Results All the patients had pathological instability after primary ACL reconstructions. In this group, 2 cases received primary bone transplantation. The other 10 cases received primary ACL revision reconstructions. Among them, 4 cases were reconstructed with STG obtained from the same lateral, 4 cases were obtained from the opposite lateral, 1 case was reconstructed with B-PT-B obtained from the same lateral and 1 case was reconstructed with iliotibiali tractus. One year later, the mean side-to-side difference of KT-2000 examination were 1.6mm and 3.1mm at 90癮nd 30?The mean IKDC, Lysholm and Tegner scores were 72.8, 78.3 and 4er.9. Conclusion The functional results and objective stability could be obtained through revision ACL recon