目的:对后交叉韧带结构和生物力学的研究表明,双束重建更接近正常后交叉韧带.半腱肌与股薄肌可对抗股四头肌收缩所导致的胫骨前移,具有稳定膝关节的作用,那么切取半腱肌和股薄肌行双束重建后交叉韧带是否具有相同的效果呢?观察自体半腱肌腱和股薄肌腱双束重建膝关节后交叉韧带的临床疗效.方法:选择2006-03/2007-12内蒙古林业总医院骨科应用半腱肌腱和股薄肌腱Y形重建后交叉韧带随访18个月以上患者9例,男8例,女1例,年龄21-42岁.单纯后交叉韧带损伤4例,合并半月板损伤5例.于患者胫骨附着部游离半腱肌腱和股薄肌腱.在后交叉韧带前束及后束股骨附着部分别钻直径5 mm隧道,在后交叉韧带胫骨附着部钻直径8.0 mm隧道,用半腱肌腱重建后交叉韧带前束,用股薄肌腱重建后交叉韧带后束,在胫骨隧道外保留半腱肌和股薄肌腱的附着点,在股骨隧道外将半腱肌和股薄肌腱打结固定,不需要内固定物.所有患者术前及术后18个月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30°位阳性;术前Lysholm-ll评分平均55分(45～68分),手术后18个月Lysholm-ll评分平均88分(78～94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步随访. 月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30° 阳性;术前Lysholm-ll评分平均55分(45-68分),手术后18个月Lysholm-ll评分平均88分(78～94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步随访. 月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30° 阳性;术前Lysholm-ll评分平均55分(45-68分),手术后18个月Lysholm-ll评分平均88分(78～94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步
目的:對後交扠韌帶結構和生物力學的研究錶明,雙束重建更接近正常後交扠韌帶.半腱肌與股薄肌可對抗股四頭肌收縮所導緻的脛骨前移,具有穩定膝關節的作用,那麽切取半腱肌和股薄肌行雙束重建後交扠韌帶是否具有相同的效果呢?觀察自體半腱肌腱和股薄肌腱雙束重建膝關節後交扠韌帶的臨床療效.方法:選擇2006-03/2007-12內矇古林業總醫院骨科應用半腱肌腱和股薄肌腱Y形重建後交扠韌帶隨訪18箇月以上患者9例,男8例,女1例,年齡21-42歲.單純後交扠韌帶損傷4例,閤併半月闆損傷5例.于患者脛骨附著部遊離半腱肌腱和股薄肌腱.在後交扠韌帶前束及後束股骨附著部分彆鑽直徑5 mm隧道,在後交扠韌帶脛骨附著部鑽直徑8.0 mm隧道,用半腱肌腱重建後交扠韌帶前束,用股薄肌腱重建後交扠韌帶後束,在脛骨隧道外保留半腱肌和股薄肌腱的附著點,在股骨隧道外將半腱肌和股薄肌腱打結固定,不需要內固定物.所有患者術前及術後18箇月做膝關節屈麯30°、60°、90°後抽屜試驗,用Lysholm-ll評分評定膝關節功能及運動水平.結果:9例患者均進入結果分析.術前9例患者所有角度後抽屜試驗暘性,術後18箇月,8例所有角度後抽屜試驗陰性,僅1例屈膝30°位暘性;術前Lysholm-ll評分平均55分(45～68分),手術後18箇月Lysholm-ll評分平均88分(78～94分),總優良率89%.結論:應用胭繩肌腱雙束重建後交扠韌帶,接近正常後交扠韌帶解剖結構,有良好的動態穩定性,臨床療效滿意,但因例數有限,遠期療效有待于進一步隨訪. 月做膝關節屈麯30°、60°、90°後抽屜試驗,用Lysholm-ll評分評定膝關節功能及運動水平.結果:9例患者均進入結果分析.術前9例患者所有角度後抽屜試驗暘性,術後18箇月,8例所有角度後抽屜試驗陰性,僅1例屈膝30° 暘性;術前Lysholm-ll評分平均55分(45-68分),手術後18箇月Lysholm-ll評分平均88分(78～94分),總優良率89%.結論:應用胭繩肌腱雙束重建後交扠韌帶,接近正常後交扠韌帶解剖結構,有良好的動態穩定性,臨床療效滿意,但因例數有限,遠期療效有待于進一步隨訪. 月做膝關節屈麯30°、60°、90°後抽屜試驗,用Lysholm-ll評分評定膝關節功能及運動水平.結果:9例患者均進入結果分析.術前9例患者所有角度後抽屜試驗暘性,術後18箇月,8例所有角度後抽屜試驗陰性,僅1例屈膝30° 暘性;術前Lysholm-ll評分平均55分(45-68分),手術後18箇月Lysholm-ll評分平均88分(78～94分),總優良率89%.結論:應用胭繩肌腱雙束重建後交扠韌帶,接近正常後交扠韌帶解剖結構,有良好的動態穩定性,臨床療效滿意,但因例數有限,遠期療效有待于進一步
목적:대후교차인대결구화생물역학적연구표명,쌍속중건경접근정상후교차인대.반건기여고박기가대항고사두기수축소도치적경골전이,구유은정슬관절적작용,나요절취반건기화고박기행쌍속중건후교차인대시부구유상동적효과니?관찰자체반건기건화고박기건쌍속중건슬관절후교차인대적림상료효.방법:선택2006-03/2007-12내몽고임업총의원골과응용반건기건화고박기건Y형중건후교차인대수방18개월이상환자9례,남8례,녀1례,년령21-42세.단순후교차인대손상4례,합병반월판손상5례.우환자경골부착부유리반건기건화고박기건.재후교차인대전속급후속고골부착부분별찬직경5 mm수도,재후교차인대경골부착부찬직경8.0 mm수도,용반건기건중건후교차인대전속,용고박기건중건후교차인대후속,재경골수도외보류반건기화고박기건적부착점,재고골수도외장반건기화고박기건타결고정,불수요내고정물.소유환자술전급술후18개월주슬관절굴곡30°、60°、90°후추체시험,용Lysholm-ll평분평정슬관절공능급운동수평.결과:9례환자균진입결과분석.술전9례환자소유각도후추체시험양성,술후18개월,8례소유각도후추체시험음성,부1례굴슬30°위양성;술전Lysholm-ll평분평균55분(45～68분),수술후18개월Lysholm-ll평분평균88분(78～94분),총우량솔89%.결론:응용연승기건쌍속중건후교차인대,접근정상후교차인대해부결구,유량호적동태은정성,림상료효만의,단인례수유한,원기료효유대우진일보수방. 월주슬관절굴곡30°、60°、90°후추체시험,용Lysholm-ll평분평정슬관절공능급운동수평.결과:9례환자균진입결과분석.술전9례환자소유각도후추체시험양성,술후18개월,8례소유각도후추체시험음성,부1례굴슬30° 양성;술전Lysholm-ll평분평균55분(45-68분),수술후18개월Lysholm-ll평분평균88분(78～94분),총우량솔89%.결론:응용연승기건쌍속중건후교차인대,접근정상후교차인대해부결구,유량호적동태은정성,림상료효만의,단인례수유한,원기료효유대우진일보수방. 월주슬관절굴곡30°、60°、90°후추체시험,용Lysholm-ll평분평정슬관절공능급운동수평.결과:9례환자균진입결과분석.술전9례환자소유각도후추체시험양성,술후18개월,8례소유각도후추체시험음성,부1례굴슬30° 양성;술전Lysholm-ll평분평균55분(45-68분),수술후18개월Lysholm-ll평분평균88분(78～94분),총우량솔89%.결론:응용연승기건쌍속중건후교차인대,접근정상후교차인대해부결구,유량호적동태은정성,림상료효만의,단인례수유한,원기료효유대우진일보
OBJECTIVE: structure and biomechanics studies of posterior cruciate ligament (PCL) demonstrated that double-bundle hamstring graft has similar function to healthy PCL. semitendinosus and gracilis can stabilize knee joint by preventing anterior tibial displacement. Therefore, the aim of this paper is to evaluate the efficacy of construction a PCL using semitendinosus and gracilis bundles.METHODS: Nine patients who were underwent double bundle PCL reconstruction from March 2006 to December 2007, and received a more than 18 months follow-up, were collected, including 8 males and 1 female, aged 21-42 years. Four patients were suffered simple PCL injury,and the other 5 patients combined with meniscus injury. Two tunnels of 5 mm diameter was made in the femoral attachment site of PCL, one tunnel of 8.0 mm diameter was made in the tibial attachment site of PCL. The anterior bundle was reconstructed using semitendinosus tendon, and the posterior bundle was reconstructed using the gracilis tendon. We reserved the attachment of the semitendinosus and gracilis tendon outside of tibial tunnel, and tied a knot using tendens outside of femoral tunnels. No internal fixation was needed. Posterior drawer test was performed in 30.60 and 90 degrees of flexion of the knee joint, and Lysholm rating system was used to determine the function of the knee and the patient's level of activity. RESULTS: Nine patients were included in the final analysis. Prior to operation, posterior drawer test in 30, 60 and 90 degrees of flexion was positive in all 9 cases. However, at 18 months after operation, posterior drawer test in 30, 60 and 90 degrees was negative in 8 cases, only 1 patient had positive posterior drawer test in 30 degrees. The mean Lysholm score was 55 points (45-68points) prior to operation, which was 88 points (78-94 points) postoperatively. The excellent and good results were obtained in 89%.CONCLUSION: Double bundle reconstruction of the PCL mimics more closely to the natural behavior of the normal PCL, which can restore normal knee laxity across the full range of motion. However, the cases were limited, so the prostecdtive efficacy needs to be followed up.
