摘要
目的评估后十字韧带三明治式重建，即保留残存纤维，采用八股胭绳肌腱双束重建后十字韧带的效果。方法2005年1月至2005年6月，单纯陈旧性后十字韧带损伤患者18例，男14例，女4例；年龄19-42岁，平均34岁。在关节镜下采用自体胴绳肌腱行双束四隧道重建，其中采用四股半腱肌腱重建前外侧束，四股股薄肌腱重建后内侧束，残存纤维保留于重建的双束移植物之间。通过微型钢板和纽扣悬吊式固定移植物。根据IKDC、Lysholm和Tegner评分标准进行评估。结果患者均获得2年以上随访，末次随访时发现，17例患者（94．4％）后抽屉试验阴性，1例后抽屉试验1度阳性。KT-1000检查示，双膝后向松弛度差值从术前的（9．3±1．4）mm改善为术后的（0．7±0．9）mm，两者比较差异有统计学意义（P〈0．01）。根据IKDC评估标准，16例患者（88．9％）评级正常，2例患者（11．1％）评级接近正常。IKDC主观评分从（64．1±3-3）分增加到（95．6±3．1）分（P〈0．01）。Lysholm评分从（58．6±4．4）分增加到（94．9±3．6）分（P〈0．01）。Tegner评分，术前为5．6分，末次随访时为6．9分。结论关节镜下后十字韧带三明治式重建能使88．9％的患者在术后2年得到正常的IKDC评级，11．1％的患者得到接近正常的IKDC评级。
Objective To evaluate the results of the sandwich style posterior cruciate ligament （PCL） reconstruction, namely two-bundle PCL reconstruction with eight-strand of hamstring tendons and remnant preservation. Methods From January 2005 to June 2005, 18 patients suffered isolated chronic PCL ruptures invovled in this study, which included 14 males, 4 females, with the mean age of 34 years （range, 19-42 years）. All patients underwent PCL arthroscopieal reconstructions with eight-strand of autogenous hamstring tendons in a two-bundle and four-tunnel manner, and with preservation of the remnant in between the two reconstructed bundles as well. Quadruple-stranded semitendinous tendon was used to recon- struct the anterolateral bundle, and quadruple-stranded gracilis tendon was used to reconstruct the postero- medial bundle. The grafts were fixed with a suspension technique using mini-plates and mini-buttons. The patients were followed up for a minimum of two years and evaluated according to the IKDC, Lysholm and Tegner rating scale. Results At the final follow-up, posterior drawer test showed negative in 17（94.4%） patients; while positive in 1 patient. The average KT-1000 examination results changed from （9.3±1.4） mm preoperatively to （0.7±0.9） mm postoperatively （P〈 0.01）. According to the IKDC knee examination form, 16 patients （88.9%） were graded normal, 2 patients （11.1%） were graded nearly normal. The IKDC subjective results increased from 64.1±3.3 to 95.6±3.1 （P〈 0.01）, and the Lysholm score increased from 58.5±4.4 to 94.9±3.6 （P〈 O.01）. The average Tegner score was 5.6 before surgery and 6.9 at the final follow-up. Conclusion Arthroscopic sandwich style PCL reconstruction can get 88.9% normal and ll.l% nearly normal IKDC results at a minimum of two years.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2008年第11期881-886,共6页
Chinese Journal of Orthopaedics
关键词
后交叉韧带
关节镜检查
创伤和损伤
Posterior cruciate ligament
Arthroscopy
Wounds and injuries
