摘要
目的:探讨应用同种异体跟腱双束重建后交叉韧带(posteriorcrucialligament,PCL)的方法并观察其早期效果。方法:2003年3月～2004年8月,对10例PCL受损患者实施关节镜下采用同种异体跟腱双束重建PCL术。其中2例合并前交叉韧带(anteriorcrucialligament,ACL)损伤,同期取自体半腱股薄肌腱重建ACL;3例合并半月板后外侧角损伤,同期取自体半腱股薄肌腱重建后外侧角。术后随访6～24个月,平均13.2个月,其中6例获得12个月以上的随访。结果:采用Lysholm评分法评价患者手术前后患膝关节功能,术前平均50.3分,术后平均91.2分。客观检查结果显示,术前所有患者均出现胫骨结节后沉,后抽屉试验及Lachman试验阳性;术后所有患者后抽屉试验及Lachman试验阴性,有3例病史较长(大于1年)的患者胫骨结节有轻度后沉。合并ACL损伤的2例患者,膝关节屈曲活动轻度受限(5°～20°)。结论:应用同种异体跟腱双束重建PCL可减少自体取材造成的损伤及相应的并发症;提前制作供材,软腱端容易通过骨道,缩短镜下操作时间,减轻手术创伤。
Objective To describe an alternative procedure of arthroscopic double - bundle posterior crnciate ligament （PCL）reconstruction using deep - frozen fresh -up outcome in early stage. Methods The ruptured PCL frozen fresh allogenic achilles tendon preparing in Y- shaped allogenic achilles tendon and evaluate the follow was reconstructed under arthroscopy using deep allografts, one bundle was used for anterolateral bundle, the other for posteromedial bundle. Absorbable screw was used to fix the soft tendon graft and metal screw was used to fix the bone graft. Results From March 2003 to August 2004, the procedure of arthroscopic double - bundle PCL reconstruction using allogenic achilles tendon was applied in 10 cases. The average follow - up period was 13.2 months（6-24 months, among them 6 cases were more than 12 months ）. 2 cases with anterior crnciate ligament （ACL） injury were also reconstructed with hamstring tendons （semitendinosus and gracilis）. 3 cases with rupture of postolateral horn tendons. Clinical results were carefully compared of knee joint were anatomically reconstructed with hamstring using the Lysholm score system before and after the operation, the average score was 50.3 preoperatively, and 91.2 postoperatively. The objective examination showed that the tibia post - migrating sign, posterior drawer test and Lachman test were positive in all the 10 cases preoperatively; whereas the posterior drawer test and Lachman test were negative postoperatively; the tibia post -migrating sign were weak positive in 3 cases with longer clinical histories（ more than 1 year）; the flexion range of the knee were slightly restricted （5°- 20°） in the 2 cases with simultaneous ACL injury. Conclusions Allogenic achilles tendon is an ideal material for arthroscopic double - bundle PCL reconstruction. Arthroscopic double - bundle reconstructed PCL is in accordance with the anatomy and physiology injury and complications caused by the autograft can be alleviated. The allograft can be and the soft end of the implant can pass through the bone tunnel easily, and thus the arthroscopy can be saved and the trauma caused by arthroscopy is abated. Arthroscopic reconstruction is sample, safe and effective. Key words arthroscopy, posterior cruciate ligament, transplantation, homologous of natural PCL. The prepared in advance operaton time under double - bundle PCL reconstruction is sample, safe and effective.
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2005年第6期685-688,共4页
Chinese Journal of Sports Medicine
关键词
关节镜
后交叉韧带
同种异体
重建
arthroscopy, posterior cruciate ligament, transplantation, homologous
作者简介
通讯作者：胡光亮，Email；huguangliang@medmail．com．cn：Tel：0532—82771900
