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关节镜下自体髌腱重建前交叉韧带及有关问题的探讨 |
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黄华扬 丁焕文 刘景发 尹庆水 刘少喻
【摘要】目的报告关节镜下自体髌腱中1/3重建前交叉韧带(ACL)，并分析影响手术效果的因素。方法采用关节镜下自体骨－髌腱－骨（BPTB）中1/3重建ACL。手术15例，男10例，女5例。年龄21～40岁，平均26岁。术后随访5～19个月，平均随访13个月。术前抽屉试验15例均阳性，术后2例阳性；轴移试验3例阳性，术后均消失；Lachman试验15例阳性，术后2例弱阳性；膝前疼痛3例。结果按照日本骨科学会制定的膝关节疗效评定标准，优6例、良6例、中3例，优良率达80.0％。结论术中选择等长点，测量关节内重建韧带的长度，获取标准的髌腱两端骨块及胫骨、股骨隧道，并正确使用挤压螺钉固定两骨块于隧道中是减少并发症，提高手术效果的关键。该手术创伤小，关节内环境影响小，可同时进行关节内其他手术，术后恢复快，是ACL重建的优良方法。
【关键词】关节镜检查 膝关节 髌韧带 前交叉韧带
Arthroscopic Reconstruction of Anterior Cruciate Ligament Using Autogenous Patellar Tendon and Evaluation of Clinical Results
HUANG Huayang, DING Huanwen, LIU Jingfa, et al.
Department of Orthopaedics， Guangzhou General Hospital of Guangzhou Military Command， Guangzhou 510010
【Abstract】 Objective To report the methods of arthroscopic reconstruction of anterior cruciate ligament (ACL)by bone－patellar tendon－bone (B－PT－B) and to evaluate the clinical resutls. Methods A technique of arthroscopic reconstruction of the anterior cruciate ligament using the mid－one third of the autologous bone－patellar tendon－bone strip was used in 15 cases. Including 10 females and 5 males，with an age range of 21 to 42 years (mean 21 years).Follow-up period extended from 5 to 19 months (mean 13 months).The anterior drawer test was positive in 15 cases preoperatively and 2 cases postoperatively. The pivot shift test was positive in 3 cases preoperatively and negative in all postoperatively. The Lachman’s test was positive in 15 cases preoperatively and 2 cases weakly positive after the operation.Three cases still had anterior patellar pain.Results According to the criteria of knee joint function evaluation set up by the Japenese Association of Orthopaedics,excellent results were found in 6 patients, good in 6 and fair in 3.The excellent and good rate was 80.0％.Conclusions The procedure not only has the advantage of minimal injury,rapid rehabilitation but also can deal with the other pathological co[1] [2] 下一页
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