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1、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（AnteriorCruciateLigament,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A
2、CL翻修手术，重建移植物用同侧腘绳肌腱（STG）4例，对侧STG4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
3、anteriorcruciateligamentreconstructionandclinicalresearch.MAYong,AOYing-fang,CUIGuo-qing,YUJia-kuo,XIAOJian,GONGXi,YANHui,YANGYu-ping,CHENGXU,XIEXing.InstituteofSportsMedicine,ThirdHospitalofPekingUniversity,Beijing100083,ChinaCorrespondingauthor：AOY
4、ing-fang，Email：yingfang.ao@vip.sina.com【Abstract】ObjectiveToanalyzethemanagementprincipleofACLrevisionreconstructionandthefactorscontributingtoitsresult.Methods12patientsreceivedACLrevisionreconstructionsfromNovember2001toJuly2006werestudiedretrospec
5、tively.Weanalyzetheindicationoftheoperation,themanagementduringtheprocedureandtheclinicalresultsaccordingtothedataabove.ResultsAllthepatientshadpathologicalinstabilityafterprimaryACLreconstructions.Inthisgroup,2casesreceivedprimarybonetransplantation
6、.Theother10casesreceivedprimaryACLrevisionreconstructions.Amongthem,4caseswerereconstructedwithSTGobtainedfromthesamelateral,4caseswereobtainedfromtheoppositelateral,1casewasreconstructedwithB-PT-Bobtainedfromthesamelateraland1casewasreconstructedwit
7、hiliotibialitractus.Oneyearlater,themeanside-to-sidedifferenceofKT-2000examinationwere1.6mmand3.1mmat90°and30°.ThemeanIKDC,LysholmandTegnerscoreswere72.8,78.3and4.9.ConclusionThefunctionalresultsandobjectivestabilitycouldbeobtainedthroughrevisionACLr
8、econstruction.However,outcomeswerelessfavorablethanthosewithprimaryreconstructions,whichmightberelatedtothefactorsincludingdeficiencyofprevioussurgeryandimpactofrevisionprocedure.【Keywords】Anteriorcruciateligament,Reconstruction，Revision,Arthroscopy膝
