Wang Lei, Zhao Huiwen, Liu Jun
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Feb;30(2):148-51.
To evaluate the effectiveness of semitendinous and gracilis transfer for the treatment of medial collateral ligament (MCL) injury caused by total knee arthroplasty (TKA).
Between March 2009 and May 2014, 11 patients (11 knees) with MCL injuries caused by primary TKA were treated by semitendinous and gracilis transfer in primary TKA (injury group). Another 18 patients (21 knees) without MCL injury were included as the control group. There was no significant difference in gender, age, injury sides, disease duration, body mass index, knee varus deformity, and preoperative Knee Society Score (KSS) between 2 groups (P>0.05), with comparability. KSS score was used to evaluate the function after operation.
Primary healing of incision was obtained in all patients, and no complications of joint instability and pain occurred. The follow-up time was-6-29 months in injury group and was 7-34 months in control group. At last follow-up, the KSS clinical score and ftinctional score were significantly increased to 89.82 +/- 3.76 and 89.54 +/- 3.50 in the injury group (P<0.05) and were significantly increased to 90.19 +/- 3.39 and 90.00 +/- 3.53 in the control group (P<0.05) respectively, but no significant difference was shown between 2 groups (t=0.158, P=0.877; t=0.820, P=0.432). X-ray films showed no prosthetic loosening or subsidence during follow-up.
The semitendinous and gracilis transfer is reliable for the treatment of MCL injury caused by TKA. The insertions of semitendinous tendon and gracilis are close to that of the knee MCL, which can effectively improve knee function.
评估半腱肌和股薄肌转移术治疗全膝关节置换术（TKA）所致内侧副韧带（MCL）损伤的有效性。
2009年3月至2014年5月，11例因初次TKA导致MCL损伤的患者（11膝）在初次TKA中接受半腱肌和股薄肌转移术治疗（损伤组）。另纳入18例无MCL损伤的患者（21膝）作为对照组。两组在性别、年龄、损伤侧、病程、体重指数、膝内翻畸形及术前膝关节协会评分（KSS）方面差异均无统计学意义（P>0.05），具有可比性。采用KSS评分评估术后功能。
所有患者切口均一期愈合，未发生关节不稳定及疼痛等并发症。损伤组随访时间为629个月，对照组为734个月。末次随访时，损伤组KSS临床评分及功能评分分别显著提高至89.82±3.76和89.54±3.50（P<0.05），对照组分别显著提高至90.19±3.39和90.00±3.53（P<0.05），但两组间差异无统计学意义（t=0.158，P=0.877；t=0.820，P=0.432）。随访期间X线片显示假体无松动或下沉。
半腱肌和股薄肌转移术治疗TKA所致MCL损伤可靠。半腱肌和股薄肌的止点与膝关节MCL的止点相近，可有效改善膝关节功能。
