Bai Lunhao, Cheng Liangliang, Wang Jiashi, Wang Guangbin, Wang Yong, Lv Dapeng, Fu Haiping, Shen Tao
Department of Orthopaedics, Shengjing Hospital, China Medical University, Shenyang Liaoning, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Feb;22(2):234-8.
To explore the short-term clinical effects on application of absorbable RIGIDfix cross pins and Intrafix screw for posterior cruciate ligament (PCL) reconstruction with autogenetic or xenogenic semitendinosus-plus-semimembranosus tendons under arthroscope.
From June 2005 to January 2007, 36 cases of PCL injuries (including 20 fresh injuries and 16 old ones) were treated. There were 21 males and 15 females, aged 15-51 years old, mean 30.4 years. There were 19 cases in the left side and 17 cases in the right side. Thirteen cases out of them complicated with medial collateral ligament injury; 9 cases complicated with lateral collateral ligament injury; 2 cases complicated with posterolateral structure injury; 11 cases complicated with medial meniscus injury; 10 cases complicated with lateral meniscus injury; 2 cases complicated with nerve and vascular injury. PCL reconstruction was accomplished by arthroscopy with autogenetic or xenogenic 4-strand semitendinosus-plus-semimembranosus tendons. RIGIDfix cross pins were used for tibial side fixation, and Intrafix was used for femoral side fixation. Lysholm scores, international knee documentation(IKDC) grading and Lachman experiment were used for evaluation before operation and in the follow up.
All the cases had been followed up for 6 to 26 months (average 10.4 months). IKDC grading showed that 3 patients (8.4 %) were graded as B, 12 patients (33.3%) as C, 21 patients (58.3%) as D before operation, while 9 patients (25 %) were graded as A, 21 patients (58.3%) as B, 6 patients (16.7%) as C after operation. Lysholm scores raised from 42.52 +/- 5.24 before operation to 91.24 +/- 5.68 after operation. Lachman experiment results showed that there were 5 cases (+), 20 cases (++) and 11 cases (+++) before operation, while there were 2 cases (+) and 34 cases (-) after operation. Each index was significant between before and after surgery (P < 0.05). After surgery, all the cases got good pain relief. Joint was stable, and motion range recovered. No pin and screw loosening was found. Only 4 cases suffered from effusion and synovitis after surgery, and they were recovered after conservative treatment.
The method of using RIGIDfix-Intrafix complexes under arthroscopy for PCL reconstruction is simple and the fixation is rigid. Early functional exercise after operation is possible.
探讨关节镜下应用可吸收RIGIDfix交叉克氏针和Intrafix螺钉，采用自体或异体半腱肌加半膜肌肌腱重建后交叉韧带（PCL）的短期临床效果。
2005年6月至2007年1月，治疗36例PCL损伤患者（包括20例新鲜损伤和16例陈旧损伤）。男21例，女15例，年龄15 - 51岁，平均30.4岁。左侧19例，右侧17例。其中13例合并内侧副韧带损伤；9例合并外侧副韧带损伤；2例合并后外侧结构损伤；11例合并内侧半月板损伤；10例合并外侧半月板损伤；2例合并神经和血管损伤。采用关节镜下自体或异体4股半腱肌加半膜肌肌腱完成PCL重建。RIGIDfix交叉克氏针用于胫骨侧固定，Intrafix用于股骨侧固定。术前及随访时采用Lysholm评分、国际膝关节文献委员会（IKDC）分级和Lachman试验进行评估。
所有病例均随访6至26个月（平均10.4个月）。IKDC分级显示，术前3例（8.4%）为B级，12例（33.3%）为C级，21例（58.3%）为D级；术后9例（25%）为A级，21例（58.3%）为B级，6例（16.7%）为C级。Lysholm评分从术前的42.52±5.24提高到术后的91.24±5.68。Lachman试验结果显示，术前5例（+），20例（++），11例（+++）；术后2例（+），34例（-）。各项指标术前与术后比较差异均有统计学意义（P < 0.05）。术后所有病例疼痛均明显缓解。关节稳定，活动范围恢复。未发现克氏针和螺钉松动。仅4例术后出现积液和滑膜炎，经保守治疗后恢复。
关节镜下应用RIGIDfix - Intrafix组合进行PCL重建的方法操作简单，固定牢固。术后可早期进行功能锻炼。
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