关节镜下运用lars人工韧带重建膝前交叉韧带

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1、关节镜下运用LARS人工韧带重建膝前交叉韧带作者：徐又佳，董启榕，周海滨，陈海南，王向利，汪益，谢宗刚，茅泳涛，郑祖根【摘要】［目的］探讨在关节镜下运用“LARS人工韧带”重建膝前交叉韧带的手术方法和临床疗效。［方法］2006年6月起运用法国LARS膝关节前交叉韧带治疗急性前交叉韧带断裂15例，男11例，女4例，年龄22～51岁（平均26.8岁）。所有患者术前Artoscan均提示前交叉韧带连续信号中断，膝关节Lysholm评分平均50分。治疗在关节镜下完成，股骨隧道口定位在外髁内侧面140°弓形弧的中心点，胫骨隧道口定位在平台内外侧髁间嵴之间、髁间窝顶线后2～4mm

2、。骨隧道直径为7.5mm、LARS韧带直径为8mm、空心挤压螺钉直径为8mm。［结果］经平均18个月随访，术后Lysholm评分平均90分，优8例，良5例，可2例，近期优良率为86.6％。本组无术后感染、无韧带自发断裂、无韧带松动并发症。［结论］运用“LARS人工韧带”重建膝前交叉韧带可达到解剖重建，可有效恢复膝关节稳定性；关节镜下手术拥有创伤小、康复快、疗效好等微创特点。【关键词】关节镜；LARS人工韧带；前交叉韧带；重建术Abstract：［Objective］Toexploretheoperatingmethodsand14rudimentalclinicalef

3、fectsofreconstructionofanteriorcruciateligament(ACL)withtheligamentadvancementreinforcementsystem(LARS)artificialligamentsunderarthroscope.［Method］SinceJuneof2006,15patients（11malesand4females,withanaverageageof26.8years）withacuteACLrupturehavebeentreatedwiththeLARSartificialligaments.Th

4、eresultsofpreoperativeArtoscanofallpatientssuggesteddiscontinuationofACL.TheaveragescoreofLysholmonkneejointwas50points.Theoperationswerecompletedunderarthroscope.Bonetunnelsofthefemurwerelocatedatthecentralpointofarconthemedialsurfaceofectocondyleof140degree.Bonetunnelsoftibiawerelocat

5、edbetweenthemedialandlateralcondyleonthetibialplateau、2-4mmtosummitlineoffossaintercondylica.Thediameterofthebonetunnelswas7.5mmwhilethatofLARSligamentandhollowcrushingscrewwere8mm.［Result］All15patientswereavailableforfollowupwithanaverageof18months.Nopostoperativecomplicationssuchasinf

6、ection,ligamentrupture,ligamentlooseningoccurred.Theclinicalresultsweregradedasbeingexcellentin8patients,goodin5andfairin2accordingtotheLysholm'sclassification.Theexcellentandgoodratewas86.6%.［Conclusion］Theanatomicalreconstructionandthestability14ofthekneejointcanbeobtainedafterACLrecon

7、structionwithLARSartificialligaments.Theoperationunderarthroscopehasadvantagesoflessinjury,rapidrecoveryandsatisfactorycurativeeffect.Keywords：arthroscopy;LARSartificalligament;anteriorcruciateligament(ACL);reconstruction　　膝前交叉韧带是膝关节稳定的重要结构之一，前交叉韧带断裂可引起胫骨与股骨相对移动，可发生胫骨伸直位