关节镜下解剖等长重建技术在重建前交叉韧带中的应用.doc

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1、关节镜下解剖等长重建技术在重建前交叉韧带中的应用【摘要】探讨前交叉韧带（ACL）解剖等长重建技术在关节镜下应用的可行性及近期疗效。［方法］对20例前交叉韧带损伤行关节镜下ACL重建木。采用前交叉韧带解剖等长重建技术钻胫骨、股骨骨道。移植物用LARS人工韧带11例，用四股半腱肌股薄肌腱9例。LARS人工韧带用2枚界面螺钉固定韧带，四股半腱肌股薄肌腱股骨端用Endobutton固定、胫骨端用可吸收界面螺钉固定。［结果］手术时间LARS人工韧带组30～80min，平均56min。四股半腱肌股薄肌腱组80～120min，平均100min。20

2、例均随访6～12个月，平均9个月。根据Lysholm膝关节功能评分，LARS人工韧带组术前评分：22～65分(36.72±15.54)分；术后6个月评分：80～98分(90.45±4.68)分(t=10.535，P<0.01)。四股半腱肌股薄肌腱组：术前评分：20～60分(37.11±12.26)分；术后6个月评分：75～87分(80.44±4.16)分(t=9.615，P<0.01)。术后6个月LARS人工韧带组与四股半腱肌股薄肌腱组评分在统计学上有显著差异(t=10.569，P<0.01)。［结论］前交叉韧带解剖

3、等长重建技术在关节镜下重建前交叉韧带术中操作简便，效果可靠，值得推广。LARS人工韧带组近期疗效明显优于四股半腱肌股薄肌腱组。【关键词】关节镜前交叉韧带人工韧带膝关节等长点Abstract：［Objective］TostudythefeasibilityandshorttermeffectsofthearthroscopicreconstructionofACLwithLARSartificialligamentsandquadruplehamstringtendonautograftusirganatomicalisometric

4、technique.［Method］ArthroscopicACLreconstructionwascarriedoutin20patientswithACLinjuriesbyusingtheLARSartificialligamentsandquadruplehamstringtendonautograft.BonetunnelsofthefemurandthetibiawerepreparedwithACLanatomicalisometrictechnique.20patientsweredividedintoLARSarti

5、ficialligamentsgroup(11patients)andquadruplehamstringtendongroup(9patients).Theartificialtendongroupwasinsertedintothetunnelsandfixedwithtwointerfacescrewsafterbeingtightened.Quadruplehamstringtendongroupwasfixedwithendobuttonplate.［Result］Theoperationtimewere30～80min(m

6、ean,56min)inLARSartificialligamentsgroupand80~120min(mean,100min)inquadruplehamstringtendongroup.NopostoperativecomplicationssuchassynovitisandligamentruptureandmovementrestrictionoccurrediFtwogroups.Afollow-upcheckupwasmadeinthe20patientsfor6～12months(mean,9months).The

7、Lysholmscoresimprovedfromapreoperativescoreof22～65(36.72～15.54)to80～98(90.45～4.68)atfollow-up(t=10.535,P<0.01)inLARSartificialligamentsgroup,andfromapreoperativescoreof20～60(37.11±12.26)to75～87(80.44～4.16)atfollow-up(t=9.615,P<0.01)inquadruplehamstringtendongroup.

8、Thereweresignificantdifference6intheLysholmscoresbetweenLARSartificialligamentsgroupandquadruplehamstringtendo