Zhang Chunlei, Chen You, Huang Guoliang, Zhu Yingchun, Zhang Wei, Li Juyuan
Department of Orthopedics, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Mar;34(3):216-20.
To explore surgical reconstruction and clinical effect of arthroscopic double-bundle double-tunnel reconstruction of anterior cruciate ligament (ACL) with multi-strand hamstring tendons autograft.
Twenty-one patients (13 males and 8 females) with ACL deficiency were diagnosed with arthroscopy, with an average age of 25.4 (17 approximately 50) years. The 2 separate tibial tunnels and 2 femoral tunnels were drilled on the footprint of the ACL to reconstruct the anteromedial and posterolateral bundles with arthroscopy.Tendons were fixed with Endo-button/polyester tape constructs at the femoral side and with biodegradable interference screw at the tibial side.
All patients were followed up for 15.8 (13 approximately 23) months. The anterior drawer test was positive in all patients and Lachman test was positive in all but 2 preoperatively. The postoperative results of anterior drawer test were negative in all but 1 at 90 degree of knee flextion. Lachman test was positive in 1, suspiciously positive in 1 and negative in other patients. The Lysholm knee score increased from 36 approximately 58 preoperatively to 71 approximately 95 postoperatively and the fineness rate was 95.2%.
Arthroscopic double-bundle double-tunnel reconstruction ACL with multi-strand hamstring tendons autograft is effective and reliable to restore the better dynamic stability of the knee.
探讨关节镜下采用多股自体腘绳肌腱双束双隧道重建前交叉韧带（ACL）的手术方法及临床效果。
对21例ACL损伤患者（男13例，女8例）行关节镜检查，平均年龄25.4岁（17～50岁）。在ACL附着点处钻2个独立的胫骨隧道和2个股骨隧道，关节镜下重建前内侧束和后外侧束。股骨侧采用Endo-button/聚酯带固定肌腱，胫骨侧采用可吸收挤压螺钉固定。
所有患者均获随访，时间15.8个月（13～23个月）。术前所有患者前抽屉试验均为阳性，Lachman试验除2例为阴性外其余均为阳性。术后屈膝90°时，除1例前抽屉试验为阳性外其余均为阴性；Lachman试验1例为阳性，1例为可疑阳性，其余为阴性。Lysholm膝关节评分由术前36～58分提高至术后71～95分，优良率为95.2%。
关节镜下采用多股自体腘绳肌腱双束双隧道重建ACL能有效恢复膝关节良好的动态稳定性，手术方法可靠。
