关节镜下多种移植物联合重建膝关节前、后交叉韧带

目的:评估关节镜下膝关节前交叉韧带(ACL)与后交叉韧带(PCL)同时重建的技术和临床效果。方法:自2003年6月～2009年10月,27例病人(28膝)经MRI检查及关节镜检查证实ACL和PCL均断裂,其中9膝伴内侧副韧带损伤(MCL),8膝伴后外侧角损伤(PLC),5膝伴内侧半月板破裂,4膝伴外侧半月板损伤。27例患者于伤后3～10周在关节镜下行膝关节前、后交叉韧带联合重建。结果:本组术后早期均未发生严重并发症。术后随访12～88个月,平均(42.67±3.34)个月,Lysholm膝关节功能评分为78～93分,平均(86.67±5.21)分。国际膝关节文件编制委员会(IKDC)综合评定由术前显著异常(D级)28膝,改进为随访时正常(A级)9膝、接近正常(B级)16膝、异常(C级)3膝。结论:关节镜下膝关节前交叉韧带(ACL)与后交叉韧带(PCL)同时重建创伤小、手术操作精细,术后膝关节功能恢复满意。

Reconstruction of Anterior and Posterior Cruciate Ligaments Through Uniting a Variety of Grafts Under Arthroscopy

Objective: To investigate the clinical results and techniques of simultaneous arthroscopically assisted reconstruction of anterior cruciate ligament and posterior cruciate ligament. Methods: A total of twenty-eight knees of 27 patients were diagnosed ACL and PCL abruption by MRI and arthrosopical examination, of whom 9 cases had medical collateral ligament injuries,8 case had angulus posteriolateralis, 5 cases had meniscus ruptures,4 cases had lateral meniscus injuries. All patients were treated by arthroscopical reconstruction within 3 to 10 weeks. Results: At the early stage, no complication occurred. ALL patients were followed up for 12-88 months, and the average time was 42.67±3.34. Lysholm score was between 78 and 93 after operation. The preoperation IKDC evalution were D in all knees which improved to A(9 knees), B(16 knees) and C(3 knees) postoperationly. Conclusions: The operation of ACL and PCL simultaneous reconstruction by arthroscopical technique had the advantages of less injury, subtle operation and excellent postoperation function of knees.