CAJ | 학술논문

目的：探讨关节镜下前交叉韧带（ACL）重建中单隧道双束与单隧道单束股骨端固定方法的临床试验对比研究。方法经临床及膝关节镜检查诊断的膝ACL损伤者123例采取镜下修复，股骨端分别应用Femoral-intraifx和Rigiifx两种方法行固定，其中Femoral-intraifx为单隧道双束，Rigiifx为单隧道单束；胫骨端均采用Intraifx进行固定。结果经随访4～36个月，平均17.25个月，Lachman征、前抽屉试验均为阴性，行Femoral-intraifx固定，术前Lysholm评分从28～70分，平均56.65分，术后76～97分，平均90.42分。行Rigiifx固定，术前Lysholm评分从30～71分，平均54.3分，术后74～98分，平均91.33分。结论 Femoral-intraifx和Rigiifx两种ACL重建的股骨端固定方法均能达到满意的临床效果，而Femoral-intraifx相对于Rigiifx更能达到界面固定的效果，避免了蹦极和雨刷效应，同时护套能有效保护患者肌腱免受内植物切割。螺钉的挤压效果加大了腱骨接触面积，固定强度大，有利于患者后期的腱骨愈合。重建后的ACL分成前内和后外两束，实现了单隧道双束重建，更符合其解剖形态，满足膝关节不同屈伸活动角度的稳定需求。
목적：탐토관절경하전교차인대（ACL）중건중단수도쌍속여단수도단속고골단고정방법적림상시험대비연구。방법경림상급슬관절경검사진단적슬ACL손상자123례채취경하수복，고골단분별응용Femoral-intraifx화Rigiifx량충방법행고정，기중Femoral-intraifx위단수도쌍속，Rigiifx위단수도단속；경골단균채용Intraifx진행고정。결과경수방4～36개월，평균17.25개월，Lachman정、전추체시험균위음성，행Femoral-intraifx고정，술전Lysholm평분종28～70분，평균56.65분，술후76～97분，평균90.42분。행Rigiifx고정，술전Lysholm평분종30～71분，평균54.3분，술후74～98분，평균91.33분。결론 Femoral-intraifx화Rigiifx량충ACL중건적고골단고정방법균능체도만의적림상효과，이Femoral-intraifx상대우Rigiifx경능체도계면고정적효과，피면료붕겁화우쇄효응，동시호투능유효보호환자기건면수내식물절할。라정적제압효과가대료건골접촉면적，고정강도대，유리우환자후기적건골유합。중건후적ACL분성전내화후외량속，실현료단수도쌍속중건，경부합기해부형태，만족슬관절불동굴신활동각도적은정수구。
Objective To explore the clinical control results of single tunnel double bundle and single tunnel single bundle femoral reconstruction ifxation technique of ACL reconstruction under arthroscopy. Methods The arthroscopic technique was employed to repair the anterior cruciate ligament injury of knee of 123 patients diagnosed by the clinical and arthroscopic examination. The femoral side was applied Femoral-intrafix and Rigiifx two kinds of ifxed method, Femoral-intraifx is single tunnel double bundle, and Rigiifx is single tunnel single bundle. Results Lachman sign and anterior drawer test were all negative at 4 to 36 monthods follow-up (average 17.25 months). In the Femoral-intraifx group, the preoperative Lysholm Score was 28 to 70, average 56.65;postoperative Lysholm Score was 76 to 97, average 90.42. In the Rigiifx group, the preoperative Lysholm Score was 30 to 71, average 54.3;the postoperative Lysholm Score was 74 to 98, average 91.33. Conclusion Both Femoral-intraifx and Rigiifx of ACL recontruction can achieve satisfactory clinical result. But Femoral-intrafix can better achieve the result of interface fixation as compared with Rigifix, avoiding the effects of bungee jumping and wipers while the protective sheath effectively protecting the tendon against cutting of implants. The squeezing effect of the screw enhance the contact area of tendon and bone and the fixation strength, and is beneifcial to the healing of tendon-bone in the later. The reconstructed ACL is divided into AM and PL two bundles, realizing the double bundles reconstruction with single-tunnel. It is more like the anatomy, and content the ifxation need of different lfexion or extension angle of the knee.