CAJ | 학술논문

目的探讨关节镜下八股腘绳肌腱双重重建前交叉韧带(ACL)的方法和手术效果.方法 2005年10月至2009年10月对49倒ACL损伤患者在关节镜下行8股腘绳肌腱双束双隧道重建ACL.取半腱肌腱折叠为4股重建前内侧束,取股薄肌腱折叠为4股重建后外侧束,做胫骨、股骨双隧道,股骨端采用缝合钢板悬吊固定,胫骨端采用缝合纽扣固定肌腱;或者取一侧的半腱肌和股薄肌肌腱折叠为4股重建前内侧柬,另一侧的半腱肌和股薄肌肌腱折叠为4股重建后外侧束,股骨端用微创钢板(Endbutton)固定,胫骨端用界面螺钉固定.采用Lysholm膝关节评分标准评价疗效.结果所有患者接受12～24个月(平均18个月)随访,除1例取腱处感染外,其余48例功能康复满意.49例患者中轴移试验Ⅰ度阳性3例,Lachman试验Ⅰ度阳性3例,屈膝90°前抽屉试验Ⅰ度阳性2例,证实膝关节稳定性良好;Lysholrn评分从术前平均(50±7)分提高到术后(93±7)分,差异有统计学意义(P<0.01).结论八股腘绳肌腱双束重建ACL术后膝关节可获得良好的稳定性.
목적 탐토관절경하팔고객승기건쌍중중건전교차인대(ACL)적방법화수술효과.방법 2005년10월지2009년10월대49도ACL손상환자재관절경하행8고객승기건쌍속쌍수도중건ACL.취반건기건절첩위4고중건전내측속,취고박기건절첩위4고중건후외측속,주경골、고골쌍수도,고골단채용봉합강판현조고정,경골단채용봉합뉴구고정기건;혹자취일측적반건기화고박기기건절첩위4고중건전내측간,령일측적반건기화고박기기건절첩위4고중건후외측속,고골단용미창강판(Endbutton)고정,경골단용계면라정고정.채용Lysholm슬관절평분표준평개료효.결과 소유환자접수12～24개월(평균18개월)수방,제1례취건처감염외,기여48례공능강복만의.49례환자중축이시험Ⅰ도양성3례,Lachman시험Ⅰ도양성3례,굴슬90°전추체시험Ⅰ도양성2례,증실슬관절은정성량호;Lysholrn평분종술전평균(50±7)분제고도술후(93±7)분,차이유통계학의의(P<0.01).결론 팔고객승기건쌍속중건ACL술후슬관절가획득량호적은정성.
Objective To describe the techniques and the results of double bundle anterior cruciate ligament(ACL) reconstruction under arthroscope using eight strands of hamstring tendon. Methods Forty-nine cases of ACL ruptures were taken reconstruction with eight-stranded hamstring tendon in a two-bundle and four-tunnel way under arthroscopy from October 2005 to October 2010. Taking four strands of semitendinous tendon to replace anterior medial bundle, four strands of gracilis tendon to build posterior lateral bundle,through double bone tunnels of tibia and femur, the ligaments were fixed using aesculap implant of braun company.Or taking four-strand of gracilis and semitendinous tendon from one side to reconstruct AM bundle, four-strand of gracilis and semitendinous tendon from the other side to reconstruct PL bundle, the grafts were fixed using Endobutton on femur side and bioscrew on tibial side. The clinical results were evaluated according to Lysholm rating scales. Results All the patients were followed up for 12 to 24 months(mean,18 months). Except one case was infected, the other 48 cases were satified with function rehabilitation. Pivot shift test was one degree positive in 3 cases, Lachman test was one degree positive in 3 cases, and anterior drawer test was one degree positive in 2 cases, proving good results of stability of the knee.The Lysholm score increased from (50±7) before operation to (93±7) after operation, there was significant difference(P<0.01).Conclusions Reliable stability can be obtained after anterior cruciate ligament reconstruction using eight strands of hamstring tendon.