关节镜下运用LARS人工韧带重建膝前交叉韧带.doc

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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：徐乂佳，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)o所有患者术前Artoscan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髒内侧面140°弓形弧的中心点，胫骨隧道口定位在平台内外侧髒间皤之间、髒间窝顶线后2〜4mmo骨隧道直径

2、为7.5mm、LARS韧带直径为8mm.空心挤压螺钉直径为8min。［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%o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］Toexploretheoperatingmethodsandrudimentalclinicaleffectsofrecon

3、structionofanteriorcruciateligament(ACL)withtheligamentadvancementreinforcementsystem(LARS)artificial1igamentsunderarthroscope.[Method]SinceJuneof2006,15patients(11malesand4females,withanaverageageof26.8years)withacuteACLrupturehavebeentreatedwiththeLARSartificialligaments・Theresultsofpreoper

4、ativeArtoscanofal1patientssuggesteddiscontinuationofACL.TheaveragescoreofLysholmonkneejointwas50points.Theoperationswerecompletedunderarthroscope.Bonetunnelsofthefemurwerelocatedatthecentralpointofarconthemedialsurfaceofectocondyleof140degree.Bonetunnelsoftibiawerelocatedbetweenthemedialandla

5、teralcondyleonthetibialplateau^2-4mmtosummitlineoffossaintercondylica.Thediameterofthebonetunnelswas7.5mmwhilethatofLARS1igamentandhollowcrushingscrewwere8ihitl[Result]All15patientswereavailableforfollowupwithanaverageof18months.Nopostoperativecomplicationssuchasinfection,1igamentrupture,1iga

6、mentlooseningoccurred>Theclinicalresultsweregradedasbeingexcellentin8patients,goodin5andfairin2accordingtotheLysholm'sclassification.Theexcellentandgoodratewas86.6%.[Conclusion]TheanatomicalreconstructionandthestabilityofthekneejointcanbeobtainedafterACLreconstruetionwithLARSa/rtificial1igame

7、nts.Theoperationunderarthroscopehasadvantagesoflessinjury,rapidrecoveryandsatisfactorycurativeeffect.Keywords：arthroscopy;LARSartifical1igament;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，可发生胫骨伸直位的外旋不稳