摘要
[目的]探讨关节镜下一期重建前、后交叉韧带联合有限切开修复内侧副韧带Ⅲ度损伤恢复膝关节稳定和功能的疗效。[方法]2008年5月-2012年9月,收治36例膝关节前交叉韧带（anterior cruciate ligament,ACL）、后交叉韧带（posterior cruciateligament,PCL）损伤及合并内侧副韧带（medial collateral ligament,MCL）Ⅲ度损伤的患者。男25例,女11例;年龄18-61岁,平均43岁。交通事故伤12例,扭伤11例,砸伤8例,高处坠落伤5例。损伤至手术时间7-26 d,平均8 d。。膝关节Lysholm评分为（16.57±7.89）分,国际膝关节文献委员会（IKDC）评分为（19.87±9.42）分,关节活动范围为（31.2±25.8）°。伴膝关节脱位6例,半月板损伤9例。关节镜下采用自体腘绳肌腱重建ACL,LARS人工韧带重建PCL,有限切开修复内侧副韧带。[结果]患者术后均获随访,随访时间为24-28个月,平均25.6个月。术后2年Lysholm膝关节功能评分为（89.23±6.08）分,关节活动范围为（122.6±10.3）°,IKDC评分为（90.32±5.26）分,与术前比较差异有统计学意义（P〈0.001）。[结论]对于膝关节多发韧带损伤,一期关节镜下重建ACL和PCL,同时配合有限切开修复MCL,创伤小,膝关节的稳定性恢复好,关节粘连发生率明显降低,可获得较好的近期疗效。
[Objective]To evaluate the effectiveness of anterior cruciate ligament（ ACL） and posterior cruciate ligament（ PCL） reconstruction combined with limited open repair of Ⅲ degree injury of medial collateral ligament（ MCL） in recovering the stability and the function of the knee. [Method]Between May 2008 and September 2012,36 knees with multiple ligament injuries of ACL,PCL and MCL were treated. There were 25 males and 11 females with an average age of 43 years（ range,18-61 years）. Injury was caused by traffic accident in 12 cases,sprain in 11 cases,bruise in 8 cases,and falling from height in 5cases. The time between injury and operation was 7- 26 days（ mean,8 days）. Lysholm score was 16. 57 ± 7. 89,the range of motion was 31. 2° ± 25. 8°,and the International Knee Documentation Committee（ IKDC） score was 19. 87 ± 9. 42. The complicated injuries included dislocation of the knee joint in 6 cases and meniscus injury in 9 cases. Autologous harmstring tendon were used to reconstruct ACL,ligament advanced reinforcement system（ LARS） were used to reconstruct PCL,and all cases underwent limited open repair of MCL. [Result]All patients were followed up for 25. 6 months on average（ range,24-28months）. After 2 year of follow- up,Lysholm score,the range of motion and IKDC score were 89. 23 ± 6. 08,122. 6 ± 10. 3°and 90. 32 ± 5. 26,respectively,showing significant differences when compared with preoperative scores（ P〈 0. 001）. [Conclusion]For multiple injuries of the knee ligaments,one- stage reconstruct tionof the knee ligaments can avoid open joint chamber,reduce postoperative articular adhesion,and obtain satisfactory knee joint stability,and the effectiveness is reliable.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第4期306-309,共4页
Orthopedic Journal of China
关键词
膝关节
多发韧带损伤
修复重建
LARS
人工韧带
knee joint
multiple-ligament injury
repair and reconstruction
LARS
artificial ligament
