关节镜下同种异体肌腱重建前交叉韧带的临床研究

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1、提要目的：评价关节镜下应用同种异体肌腱重建前交叉韧带的临床疗效。材料与方法：本研究病例来自山东中医药大学附属医院运动损伤骨科病房，自2010年1月至2011年3月我科住院的经临床及关节镜检查确诊的前交叉韧带Ⅱ、Ⅲ度损伤的患者32例。所有患者均于关节镜下行同种异体肌腱重建膝关节前交叉韧带手术。所取移植肌腱均为深冻同种异体胫前肌肌腱，关节镜下行等长重建。股骨端采用横穿钉固定，胫骨端采用可吸收界面螺钉固定。本组病例均于术后1年采用Lachman试验测试、Lysholm评分和IKDC评分进行评定。结果：患者术后伤口均I期愈合，8～10周膝关节屈伸功能达到正常。本组32例均获随访，随

2、访期限为8～14个月，平均12个月。1例自觉症状改善不理想。随访时Lachman试验测试2度阳性者2例，其余均为阴性或1度阳性，优良率为93.75%(30/32)。关节活动度：0°～110°1例，0°～120°2例,0°～130°29例，原有症状减轻或消失。主、客观评价膝关节功能改善较明显，治疗效果满意。结论：关节镜下同种异体肌腱重建前交叉韧带治疗前交叉韧带Ⅱ、Ⅲ度损伤疗效良好。关键词关节镜；前交叉韧带；重建；同种异体肌腱；ClinicalStudyoftheArthroscopicReconstructionofAnteriorCruciateLigamentwithAl

3、lograftTendonSpeciality：OrthopedicsofTCMAuthor：LiWeixingTutor：AssociateProf.XiaoYiAbstractObjective:Toevaluatetheclinicalefficacyofthearthroscopicallografttendonreconstructionoftheanteriorcruciateligament.Materialsandmethods:Inthisstudy,casesfromtheorthopedicwardofsportsinjuriesintheHospit

4、alAffiliatedShandongUniversityofTraditionalChineseMedicine，formJanuary2010toMarch2011，thenumberofpatientshospitalizedinourdepartmentdiagnosedII,IIIdegreeanteriorcruciateligamentinjurybyclinicalandarthroscopicwas32cases.Allofthemhaveclearhistoryofkneeinjury.Allpatientsacceptedtheallograftte

5、ndonanteriorcruciateligamentreconstructioninthejointsmicroscope.Allthetransplantedtendonaredeep-frozenallografttibialisanteriortendon,operatedallografttendonlengthreconstructioninthejointsmicroscope.Femoralsideacrossthenail,tibialsideusingabsorbableinterferencescrewfixation.Thisgroupofpati

6、entsat1yearpostoperationallusedtheLachmantest,LysholmscoreandIKDCscoreassessment.Results:Inallpatients,PostoperativewoundhealedinphaseI,at8to10weekstheflexionandextensionfunctionofkneecametonormal.inthegroupall32caseswerefollowedup,thefollow-upperiodwas8to14months,withanaverageof12months.1

7、casessymptomsimprovednotidealy.Atthefollow-uptherearetwocasesthatLachmantestis2degreespositive,therestarenegativeor1degreepositive,thegoodrateis93.75%(30/32).Rangeofmotion:0°~110°1case,0°to120°2cases,0°to130°in29cases,theoriginalsymptomsreducedordisappeared.Su