摘要
目的探讨关节镜下重建断裂的前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)及修复膝关节内部结构,治疗膝关节脱位合并多发韧带损伤的临床疗效。方法2003年7月-2006年8月,收治24例膝关节脱位患者,采用关节镜下重建ACL和PCL,修复内侧副韧带(medial collateral ligament,MCL)、外侧副韧带(lateral collateral ligament,LCL)和其他膝关节损伤结构。男19例,女5例;年龄20～69岁,平均42岁。均为单膝损伤,其中左膝11例,右膝13例。于伤后4 h～6个月入院。ACL、PCL、MCL及LCL损伤8例,ACL、PCL及MCL损伤12例,ACL、PCL及LCL损伤4例。合并腓总神经损伤1例,内侧半月板损伤3例,外侧半月板损伤7例。评估患者术后并发症、膝关节活动范围和手术前后症状改善情况,Lysholm评分评估手术前后膝关节功能情况。结果术后患者均获随访11～36个月,平均25个月。4例出现轻微关节僵硬,3例出现轻微关节疼痛,均未作特殊处理。11例(45.8%)运动功能恢复至伤前运动水平;13例(54.2%)显著改善,不需要辅助独立行走。24例Lachman试验、膝内外翻应力试验及前、后抽屉试验均为阴性,胫骨前后移动均<5 mm。1例腓总神经损伤者感觉运动恢复良好。Lysholm膝关节功能评分术前(41.8±4.3)分,术后(87.0±6.0)分;关节活动范围术前(87.5±12.5)°,术后(125.0±9.2)°;术前、后比较差异均有统计学意义(P<0.05)。结论膝关节脱位后关节镜下重建ACL、PCL和修复其他膝关节结构是治疗膝关节脱位的一种有效方法。
Objective To investigate the dinical outcomes of the treatment of knee dislocation with multi ple ligaments injuries by anterior cruciate ligament （ACL） and posterior cruciate ligament （PCL） reconstruction under arthroscopy and repair of the injured structures of the knee joint. Methods From July 2003 to August 2006, there were 24 patients with knee dislocation （19 males and 5 females）, with the average age of 42 years （ranging from 20 years to 69 years）, whose ACL and PCL were reconstructed under arthroscopy and whose collateral 1 igaments and other structures of the knee were repaired [8 with injuries ofACL, PCL, medial collateral ligament （MCL） and lateral collateral ligament （LCL）; 12 with injuries of ACL, PCL and MCL; 4 with injuries of ACL, PCL and LCL]. There were 1 case with common peroneal nerve injury, 3 with medial meniscus injury and 7 with lateral meniscus injury. Every patient had single knee dislocation. The outcome was measured from the following aspects： range of the knee, complication, clinical improvement and Lysholm scoring. Results Twenty-four patients were followed up for 11 months to 36 months, with the average time of 25 months. Eleven patients （45.8%） recovered to the normal sports level and 13 （54.2%） patients＇ knee function improved significantly so that they could walk by themselves. Lachman test, anterior drawer test and posterior drawer test were negative in 24 patients. The side-to-side difference was less than 5 mm in 24 patients. There were 4 patients who had slight knee stiffness. One patient＇s feeling and sports function of the general peroneal nerve improved to the normal level. Lysholm scale of the knee function was 41.8 ± 4.3 preoperatively and 87.0 ± 6.0 postoperatively （P 〈 0.05）. The movement ranges of the knee were （87.5 ± 12.5）° preoperatively and （125.0 ± 9.2）° postoperatively （P 〈 0.05）. Conclusion Reconstructing the ACL and PCL and repairing other structures of the knee is an effective method to treat dislocation of the knee.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2008年第6期673-675,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
膝关节
关节脱位
多发韧带损伤
关节镜
修复重建
Knee joint Joint dislocation Multiple ligament injuries Arthroscopy Repair and reconstruction
