关节镜下同种异体肌腱移植重建前交叉韧带损伤的临床疗效观察Clinical observation of arthroscopic allograft tendon graft for reconstruction of anterior cruciate ligament injury.pdfVIP

摘 要 目的：探讨关节镜下异体同种肌腱重建膝关节前交叉韧带的手术方法及临床疗 效。 材料与方法：2009年3月--2010年3月，收治经临床及关节镜检查确诊的前交叉韧 带损伤的患者30例，男20例，女10例。年龄19～49岁，平均26.3岁。左膝18例，右膝 12例。其中运动性损伤20例，车祸伤6例，其他伤4例。均有明确膝关节外伤史。根据 临床表现及MRI检查诊断前交叉韧带损伤30例，经关节镜检查及手术确诊共30例。取 冷冻异体同种肌腱，关节镜下行同种异体肌腱等长重建前交叉韧带，股骨端和胫骨端 采用可吸收挤压钉固定。本组病例均于术后1年采用Lysholm评分和IKDC评分进行评 分。 结果：患者伤口术后均I期愈合，7～10周膝关节屈伸功能恢复正常。本组30例均 获随访6个月～14个月，平均12个月。1例自觉症状改善不明显。随访时抽屉试验和 Lachman试验疑似阳性者2例，余均为阴性。关节活动度：0°～130°28例，0°～100 °2例,原有症状消失或减轻。主观评价膝关节功能明显改善，对治疗效果满意。采用 Lysholm膝关节评分方法评估，术后评分为87.35±8.57，与术前39.87土9.65比较差异 有统计学意义。 结论： 膝关节镜下同种异体肌腱移植重建前交叉韧带损伤是治疗急、慢性前交叉 韧带损伤的较好的方法。 关键词：前交叉韧带；重建术；关节镜；异体同种肌腱 Purpose ： To explore more than arthroscopic Tendon allograft of anterior cruciate 1igament reconstruction of the application and therapeutic effect of the surgical methods and clinical clinical efficacy Material and method ：From December 2009 to June 2010 ，30 cases of ruptures of ACLs are diagnosed by clinical and arthroscopic examinations ．There were20 males and 10 females with an average age of 26.3 years(19--49 years)．The locations were left knee in 18 cases and right knee in 12 cases．Exercise—induced injury of which 20 cases ，6 cases of car accident injury，4 cases of other injuries ．All patients had the history of knee joint injury ．The basis of clinical performance and MRI diagnosis of anterior cruciate iigament injury in 30 cases. Take the same kind of frozen tendon allograft, such as arthroscopic tendon allograft long line of anterior cruciate ligament reconstruction. Femoral and tibial side can be absorbed by compression screw fixation. The result was estimated by Lysholm knee scores and IKDC knee score of 1 year after surgery. Results: ALL patients achieved healing by the first intention. Knee extension and flexion function was restored normal at 7～10 weeks.