摘要
目的探索一种应用同种异体跟腱重建前十字韧带(anteriorcrucialligament,ACL)的新方法,避免自体髌腱取材造成的膝周组织再损伤及由此引起的并发症。方法关节镜下应用经深低温冷冻处理的同种异体跟腱,采用等长重建、生物固定方法,重建受损的ACL。同时还可充分利用跟腱的长度重建受损的内侧副韧带(medialcollateralligament,MCL)。结果1996年1月～2000年6月,共31例患者被施行了关节镜下应用同种异体跟腱重建ACL,25例(26侧)获得12个月以上的随访,随访时间12～49个月,平均18.9个月。其中4例同时实施了受损MCL的重建,5例行半月板缝合,6例行半月板部分切除或完全切除。采用Lysholm评分法评估患者手术前后的功能,术前平均53.5分,术后平均84分,优良率为84.6%。客观检查:前抽屉试验阳性,术前23侧,术后1侧;Lachman征阳性,术前25侧,术后1侧,2侧弱阳性。术后遗留膝关节运动后疼痛2例;膝关节活动受限(5°～20°)3例。结论应用同种异体跟腱重建ACL,供材可提前制作,减少了自体取材造成的损伤及其相应的并发症,并可同时重建MCL。该技术取材方便,手术方法简单,无须内固定。
Objective To describe a new method of reconstruction of anterior crucial ligament(ACL) so as to avoid additional injury of peripatellar tissue and complications caused by procuring autograft from the patellar tendon. Methods To reconstruct the injuried ACL under arthroscopy by means of identical length of allogenic achilles tendon which was stored in deep hypothermia. At the same time, injuried medial collateral ligament(MCL) was reconstructed by using the achilles tendon. Results From January 1996 to June 2000, the ACLs in 31 cases were reconstructed by allogenic achilles tendon under arthroscopy. The average period of follow up of 25 cases(26 sides) was 18.9 months(12-49 months). Among them, 4 injuried MCLs were also reconstructed, 5 torn meniscus were sutured, and 6 were resected or partially resected. According to the Lysholm score method, the average score was 53.5 preoperatively, and 84 postoperatively, the satisfactory rate was 84.6%. The objective examination showed anterior drawer test(ADT) positive in 23 preoperatively, 1 postoperatively; Lachman test was positive in 25 preoperatively, 1 postoperatively, and weak positive in 2 postoperatively. There were 2 with pain in knee joints and 3 with limitation of activity of knee joints(5°-20°)postoperatively. Conclusion Allogenic achilles tendon, a materials can be procured in advance, and the injury and complications caused by the autograft can be decreased, and MCL can be reconstructed at the same time. With this technique, the material is convenient to obtain, the operative method is simple, and there is no need for internal fixation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第11期670-672,共3页
Chinese Journal of Orthopaedics
