[关节镜下自体腘绳肌腱单束重建前交叉韧带治疗前交叉韧带单束断裂]

[Arthroscopic reconstruction of anterior cruciate ligament for single bundle rupture with hamstring autograft].

作者信息

Li Zhichao, Liu Yujie, Wang Zhigang, Li Zhongli, Wei Min, Cai Xu, Zhu Juanli

机构信息

Department of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Nov;24(11):1315-7.

PMID:21226352

Abstract

OBJECTIVE

To investigate the effectiveness of anterior cruciate ligament (ACL) reconstruction for single bundle rupture using hamstring autograft with preservation of the left bundle.

METHODS

Between March 2005 and May 2009, 20 patients with ACL single bundle rupture were treated using hamstring autograft with preservation of the left bundle. There were 15 males and 5 females with an average age of 25.5 years (range, 16-43 years). Injury was caused by sports in all the patients. The locations were the left knee in 12 cases and the right knee in 8 cases, including 11 cases of antero-medial bundle rupture and 9 cases of postero-lateral bundle rupture. Ten patients had positive results of anterior drawer test, 8 patients had positive result of Lachman test, and 2 patients had positive results of both tests. The Lysholm score was 67.0 +/- 6.2 and International Knee Documentation Committee (IKDC) score was 69.0 +/- 7.5. The time from injury to surgery was 1 week to 12 months (mean, 2.8 months).

RESULTS

All the patients had healing of incision by first intention. Twenty patients were followed up 18.5 months on average (range, 12-36 months). The range of motion of all the knees was more than 130 degrees at last follow-up. The results of both the anterior drawer test and Lachman test were negative in 17 patients. The result of anterior drawer test was weakly positive and the result of Lachman test was negative in 2 patients. The result of Lachman test was weakly positive and the result of the anterior drawer test was negative in 1 patient. The Lysholm score and the IKDC score were 91.0 +/- 3.7 and 92.0 +/- 4.9 at last follow-up, showing significant differences when compared with the preoperative ones (P < 0.05).

CONCLUSION

ACL reconstruction using hamstring autograft with preservation of the left bundle has satisfactory effects and can partially preserve the proprioceptive sense of the knee, which is beneficial for improving the stability of the knee.

摘要

目的

探讨保留左束的自体腘绳肌腱移植重建前交叉韧带（ACL）单束断裂的有效性。

方法

2005年3月至2009年5月，对20例ACL单束断裂患者采用保留左束的自体腘绳肌腱移植治疗。其中男性15例，女性5例，平均年龄25.5岁（16 - 43岁）。所有患者均因运动损伤所致。损伤部位为左膝12例，右膝8例，其中前内侧束断裂11例，后外侧束断裂9例。前抽屉试验阳性10例，Lachman试验阳性8例，两项试验均阳性2例。Lysholm评分67.0±6.2，国际膝关节文献委员会（IKDC）评分69.0±7.5。受伤至手术时间为1周至12个月（平均2.8个月）。

结果

所有患者切口均一期愈合。20例患者平均随访18.5个月（12 - 36个月）。末次随访时所有膝关节活动范围均超过130度。17例患者前抽屉试验和Lachman试验结果均为阴性。2例患者前抽屉试验弱阳性，Lachman试验阴性。1例患者Lachman试验弱阳性，前抽屉试验阴性。末次随访时Lysholm评分和IKDC评分分别为91.0±3.7和92.0±4.9，与术前相比差异有统计学意义（P < 0.05）。