关节镜下六股自体腘绳肌腱胫骨双隧道重建膝前交叉韧带.doc

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1、关节镜下六股自体腘绳肌腱胫骨双隧道重建膝前交叉韧带李卫平黄建荣沈慧勇宋斌宋富强宋洋广州中山大学附属第二医院骨科，广东省广州市510120[摘要]：目的介绍关节镜下采用六股“人”字形自体腘绳肌腱经胫骨双隧道重建膝前交叉韧带（ACL）的手术方法以其应用体会。方法：对32例膝关节ACL断裂的患者，取自体股薄肌及半腱肌肌腱反折编织形成六股“人”字形移植物，在关节镜监视下采用胫骨双隧道、股骨单隧道界面螺钉固定行ACL重建，观察此方法的可靠性以及近期疗效。同时行半月板部分切除成形术17例、大部分切除术2例，修补术2例；软骨损伤病灶修整6例，内侧副韧带修补3例。结果：30

2、例患者获得随访，随访时间7~22个月，平均14个月。关节活动度均正常，平均Lysholm评分由术前62.0分提高到93.2分，差异有统计学意义(t=2.469，p<0.01)，KT-1000测定平均移动度1.3±0.4mm；复查MRI显示胫骨骨隧道扩大2例，前内侧束髁间窝撞击4例；所有患者的X线照片未见明显关节间隙改变。结论：关节镜下应用六股自体腘绳肌腱经胫骨双隧道、股骨单隧道界面挤压螺钉固定重建ACL的方法创伤少，能最大限度恢复ACL的解剖重建，近期疗效佳。[关键词]膝关节前交叉韧带重建术关节镜Reconstructionanteriorcruciatel

3、igamentthroughtwintunnelsintibiausesixbundlesautoallergictendonsbyarthroscopeLiweiping;Huangjianrong;Shenhuiyong;Songbin;Songfuqiang;Songyang(DepartmentofOrthopedics,TheSecondAffiliatedHospital,SunYatSenUniversity,Guangzhou510120,China)[Abstract]:ObjectiveIntroducetheoperationmetho

4、dandthecomprehensionofreconstructionanteriorcruciateligamentthrougharthroscopebyusingsixbundlesautoallergictendons.MethodInthis32-patientwhoseanteriorcruciateligamentswerebroken,theautoallergictendonwerewoventoaflexionalsix-bundlesgraftbeforeimplant.Twintunnelsintibiaweredrilled,th

5、etendongraftswerefixedbyscrews.Allprocedureswereperformedusingastandardendoscopictechnique.Patial页：1rmeniscectomywereconductedin17casea.Largepartialmeniscectomywereconductedin2cases.Meniscusprosthesiswereunderwentin2cases.Cartilagechippingwereunderwentin6cases.MCLprosthesiswereunde

6、rwentin3cases.ResultsIttakes7to22months14inaveragetofollowup30patients.TheLysholmscoreincreasedfrom62.0to93.2averagely,differenceissignificant(t=2.469，p<0.01).KT-1000examinationshowsmeanmotionis1.3±0.4mm；MRIcallbackshows2caseshasvariousexpandingofthetunnelintibialtunnel.4anteriomed

7、ialisbundlehadadashinfossaintercondylica.AllcaseshadnonarrownessinjointspaceinX-ray.ConclusionUsingautoallergictendonstoweavetoaflexionalsixbundlesfortransplantsandusetwintunnelsintibiabyusingscrewspinninginthesurfacesthrougharthroscopehaslesstrauma.Theoutcomehavinggoodjointstabili

8、ty,thenormalanatomyconstru