关节镜微创双束重建前交叉韧带临床应用研究.docVIP

关节镜微创双束重建前交叉韧带临床应用研究 　　[摘要] 目的 探讨膝关节镜下微创双束重建前交叉韧带的手术方法及其疗效。方法 2007年2月～2011年8月，利用关节镜微创技术对163例膝关节前交叉韧带撕裂伤患者进行双束重建手术。手术采用常规关节镜髌下前内侧（AM）和前外侧（AL）入路，镜下证实前交叉韧带撕裂伤并处理合并伤后在胫骨结节内侧做斜形手术切口，取出半腱肌及股薄肌腱，修整编织，分别对折成3～4股，备用。在胫骨及股骨分别钻制2骨道（共4骨道），引入编织好的半腱肌及股薄肌。股骨端采用Endobutton翻转固定，胫骨端采用界面可吸收螺钉固定。 结果 163例患者中3例失访， 其余患者术后随访时间为12～30个月。术前、术后采用Lysholm评分，手术前Lysholm评分平均为50（43～71）分，12个月后随访时Lysholm评分平均为93（78～99）分。优良率为95%。 结论 关节镜微创双束重建前交叉韧带术仿造正常前交叉韧带的解剖结构，有效地重建了维持膝关节前后直向及轴向旋转稳定装置，术后患者膝关节稳定性得到了全面的恢复，疗效较单束重建术进一步得到了提高。 　　[关键词] 前交叉韧带；关节镜；?绳肌腱；双束重建 　　[中图分类号] R686.5 [文献标识码] A [文章编号] 1674-4721（2012）04（a）-0036-03 　　 　　The clinical research of the arthroscopic minimally invasive surgery treatment for double-bundle reconstruction of anterior cruciate ligamant 　　DENG Huaidong HUANG Zhongqiang TAN Zhichao ZHANG Binshan 　　Orthopedics Department Ⅰ(Joint Bone Department), Traditional Medical Hospital of Dongguan City in Guangdong Province, Dongguan 523000, China 　　[Abstract] Objective To investigate the operative method and clinical effect of the arthroscopic minimally invasive surgery treatment for double-bundle reconstruction of anterior cruciate ligamant. Methods February 2007 to August 2011, used of arthroscopy minimally invasive technology on 163 cases of knee torn ligament of the across before patients with double beam reconstruction surgery. The conventional arthroscopic surgery under the patellar before (AM) and anterolateral (AL) into the road, under mirror confirmed that former cross torn ligament injury and deal with the merger in tibia nodules inside did normal oblique incision, took out half a tendon muscles and tendons of thin, trim weave, were folded in half into 3 to 4 shares, set aside. In tibia and femur bone drilling system respectively 2 way (general 4 bone way), the introduction of weaving good half sinews and strands thin muscle. The up end of the tendons were fixed with Endobutton while the tibial end was fixed by interface absorbable screws. Results Postoperative follow-ups were c