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改良TransFix-II技术在双胫骨隧道关节镜下前交叉韧带重建中的应用

[Application of modified TransFix-II technique in arthroscopic reconstruction of the anterior cruciate ligament using double tibial tunnel].

作者信息

Hu Yong, Chen Jing-yong, Liu Jian-wei, Dong Xia

机构信息

Department of Sports Medicine, Sichuan Province Orthopedic Hospital, Chengdu 610041, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Dec;27(6):704-7.

Abstract

OBJECTIVE

To describe a modified TransFix- 11 technique for arthroscopic reconstruction of anterior cruciate ligament (ACL) using double tibial tunnel.

METHODS

Twelve cases of ACL ruptures were reconstructed anatomically using modified TransFix- 11 technique. The double-looped semitendinosus and gracilis (DLSTG) tendon autograft was placed in a single femoral tunnel and double tibial tunnels to replace the anteromedial (AM) and posterolateral (PL) bundles of the original ACL. All the 12 patients underwent the same postoperative accelerated rehabilitation program.

RESULTS

Lachman test, anterior drawer test and pivot shift sign, and mcmurray test showed negative results in all cases. All patients regained normal range of motion of the knee and gait 4-6 weeks after operation, and 8 patients returned to the low risk sports at 10-12 weeks. One year after operation, 9 patients were followed: the International Knee Document Committee (IKDC) analysis revealed normal or near normal knees in 9 patients. The Tegner score revealed that 6 patients regained their pre-injury activity level. No patient had a significant femoral or tibial tunnels enlargement, as shown by follow-up CT scan.

CONCLUSION

Arthroscopic ACL reconstruction with double tibial tunnel using DLSTG and the technique of modified TransFix-II is reliable for replacement of the AM and PL bundles of the original ACL. The postoperative accelerated rehabilitation and the rapid restoration of the injured knee function can be expected.

摘要

目的

描述一种改良的TransFix-11技术,用于关节镜下双胫骨隧道前交叉韧带(ACL)重建。

方法

采用改良的TransFix-11技术对12例ACL断裂患者进行解剖重建。将双股半腱肌和股薄肌(DLSTG)肌腱自体移植物置于单个股骨隧道和双胫骨隧道中,以替代原ACL的前内侧(AM)和后外侧(PL)束。所有12例患者均接受相同的术后加速康复计划。

结果

所有病例的Lachman试验、前抽屉试验、轴移试验和Mcmurray试验均为阴性。所有患者术后4-6周膝关节活动范围和步态恢复正常,8例患者在10-12周时恢复低风险运动。术后1年,对9例患者进行随访:国际膝关节文献委员会(IKDC)分析显示9例患者膝关节正常或接近正常。Tegner评分显示6例患者恢复到受伤前的活动水平。随访CT扫描显示,无患者出现明显的股骨或胫骨隧道扩大。

结论

采用DLSTG双胫骨隧道关节镜下ACL重建及改良TransFix-II技术替代原ACL的AM和PL束是可靠的。术后可实现加速康复并快速恢复受伤膝关节功能。

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