摘要
目的分析关节镜下应用改良的TransFix-Ⅱ技术经双胫骨隧道施行自体双股半腱和股薄肌腱(DLSTG)解剖重建膝前交叉韧带(ACL)的手术方法及术后随访结果。方法对12例ACL断裂患者,在关节镜下应用改良的TransFix-Ⅱ技术,经双胫骨隧道施行自体DLSTG解剖重建膝前交叉韧带。术后常规配合激进的康复训练。结果12例患者在术后6个月内随访显示:全部患者的Lachman试验、前抽屉试验和pivotshift征、mcmurray试验阴性;并在术后4￣6周恢复了正常的关节活动度和行走步态。8例患者在术后10￣12周恢复了低风险体育运动。术后12个月,9例获得随访患者的国际膝关节病历委员会(IKDC)评分为正常或接近正常,Tegner评分显示6例患者恢复了伤前运动水平。CT扫描测量证实股骨、胫骨隧道无扩大。结论关节镜下使用自体DLSTG,应用改良的TransFix-Ⅱ技术,可经双胫骨隧道解剖重建ACL前内侧束和后外侧束,术后利于开展加速的康复训练和伤膝功能的迅速恢复。
Objective To describe a modified TransFix-Ⅱ technique for arthroscopic reconstruction of anterior cruciate ligament （ACL） using double tibial tunnel. Methods Twelve cases of ACL ruptures were reconstructed anatomically using modified TransFix-Ⅱ technique. The double-looped semitendinosus and gracilis （DLSTG） tendon autograft was placed in a single femoral tunnel and double tibial tunnels to replace the anteromedial （AM） and posterolateral （PL） bundles of the original ACL. All the 12 patients underwent the same postoperative accelerated rehabilitation program. Results Lachman test, anterior drawer test and pivot shift sign, and mcmurray test showed negative results in all cases. All patients regained normal range of motion of the knee and gait 4-6 weeks after operation, and 8 patients returned to the low risk sports at 10 - 12 weeks. One year after operation, 9 patients were followed： the International Knee Document Committee （IKDC） analysis revealed normal or near normal knees in 9 patients. The Tegner score revealed that 6 patients regained their pre-injury activity level. No patient had a significant femoral or tibial tunnels enlargement, as shown by follow-up CT scan. Conclusion Arthroscopic ACL reconstruction with double tibia] tunnel using DLSTG and the technique of modified TransFix-Ⅱ is reliable for replacement of the AM and PL bundles of the original ACL. The postoperative accelerated rehabilitation and the rapid restoration of the injured knee function can be expected.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2005年第6期704-707,i0015,共5页
Acta Academiae Medicinae Sinicae
关键词
前交叉韧带
关节镜
肌腱移植
膝关节
anterior cruciate ligament
arthroscopy
tendon transfer
knee joint
