中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (15): 2680-2684.doi: 10.3969/j.issn.1673-8225.2011.15.006

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

六股自体腘绳肌腱“人”字形编织重建膝关节前交叉韧带

孙小平1，刘运晃1，刘柱同1，赵  喆2，邢更彦2，李志国2   

  1. 1武警广东总队医院骨科，广东省广州市 510507
    2武警总医院骨科，北京市100039
  • 收稿日期:2011-01-12 修回日期:2011-03-08 出版日期:2011-04-09 发布日期:2013-11-06
  • 通讯作者: 刘运晃，硕士，武警广东总队医院骨科，广东省广州市510507 liuyunhuang998@sina.com
  • 作者简介:孙小平★，男，1966年生，江西省人，硕士，副主任医师，主要从事创伤及关节研究。 sunxiaoping888@163.com

Clinical effect of anterior cruciate ligament reconstruction using six-strand hamstring grafts under a knee arthroscopy

Sun Xiao-ping1, Liu Yun-huang1, Liu Zhu-tong1, Zhao Zhe2, Xing Geng-yan2, Li Zhi-guo2   

  1. 1Orthopaedic Department, Guangdong Hospital of CAPF, Guangzhou  510507, Guangdong Province, China
    2Orthopaedic Center, General Hospital of CAPF, Beijing  100039, China
  • Received:2011-01-12 Revised:2011-03-08 Online:2011-04-09 Published:2013-11-06
  • Contact: Liu Yun-huang, Master, Orthopaedic Department, Guangdong Hospital of CAPF, Guangzhou 510507, Guangdong Province, China liuyunhuang998@ sina.com
  • About author:Sun Xiao-ping★, Master, Associate chief physician, Orthopaedic Department, Guangdong Hospital of CAPF, Guangzhou 510507, Guangdong Province, China sunxiaoping888@ 163.com

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摘要：

背景：目前不同学者对膝关节损伤前交叉韧带重建方法存较多争论，因此寻找简便、经济的修复方法是目前该领域的研究热点。
目的：观察关节镜下应用6股自体腘绳肌腱“人”字形编织重建修复前交叉韧带损伤的临床疗效。
方法：对19例单侧前交叉韧带功能不全的患者采用6股自体腘绳肌腱人字形编织，胫骨隧道钻取双隧道模拟前内、后外两束重建膝关节前交叉韧带，于重建前后利用IKDC分级，Lysholm功能评分和KT-2000TM关节动度仪测试试验，对患者进行主观和客观评分，并应用IKDC分级进行影像学评估。
结果：19例患者随访的IKDC分级：A级8例、B级10例、C级1例，无伸膝受限，活动范围120°~140°，平均126°。KT-2000TM膝关节稳定性测量在90.7 kg，136.1 kg和最大拉力时，患膝和健膝之间的关节活动度差异均无显著性意义 (P > 0.05)。随访时Lysholm膝关节功能评分显著高于重建前(P < 0.01)。影像学IKDC评估为：A级15例(79%)，B级3例(16%)，C级1例(5%)。结果证实，应用6股自体腘绳肌腱“人”字形编织双束重建前交叉韧带短期临床疗效良好。

关键词: 关节镜, 前交叉韧带, 修复, 双束腘绳肌腱, 组织构建

Abstract:

BACKGROUND: At present, there are a lot of controversial exists in the methods of anterior cruciate ligament reconstruction by different scholars. Looking for simple and economical repair methods is the research focus.
OBJECTIVE: To explore the clinical effect of arthroscopic anterior cruciate ligament (ACL) reconstruction with six-strand hamstring tendon autografts.
METHODS: Nineteen non-consecutive randomized patients with unilateral ACL insufficiency received six-strand hamstring tendon autografts reconstruction by using double tibia tunnel technique. Patients were evaluated subjectively and objectively before and after ACL reconstruction, using IKDC score, Lysholm score system, manual maximum displacement test with KT-2000TM arthrometer. Radiographic evaluation was performed according to IKDC grading system.
RESULTS AND CONCLUSION: The subjective and objective IKDC were 8 in A (42.1%), 10 in B (52.6%) and only 1 C (5.4%)and radiographic IKDC were 15 in A (78.9%), 3 in B (15.7%), 1 in C (5.4%). Passive range of motion recovery was within 120°-140° (average 126°). The measured data by KT-2000TM in normal and operated knee were 6.1±0.2 and 6.5±0.8, 6.3±0.5 and 7.1±0.9, 7.2±0.6 and 8.3±1.2, at the tensile fore of 20 pound, 30 pound and the largest, respectively. Lysholm score were 51.8±8.6 before operation and 86.5±12.3 at the last followed-up. The double bundle of ACL reconstruction by hamstring tendon autograft shows satisfactory functional results in the early period. 

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