CAJ | 학술논문

对关节镜下自体腘绳肌双股骨隧道重建后交叉韧带的近期临床疗效进行观察和分析。方法选择20例后交叉韧带（posterior cruciate ligament，PCL）损伤度为3级的患者。通过自体腘绳肌腱双股骨隧道和单胫骨隧道的方法对PCL重建。术前屈膝活动度为（120.5±3.8）°。患者随访18~30个月,平均25个月。结果手术后患者屈膝的活动度为（117.3±2.7）°，相比于术前没有显著性差异（P>0.05），没有出现伸膝受限，且侧扳试验结果都是阴性。患者术后的后抽屉试验结果为（1.3±0.5）°，Lysholm的术前评分为（50.6±7.2）分，术后评分为（93.2±2.8）分，Tegner术前评分为（1.3±0.6）分，术后评分为（6.2±0.8）分。胫骨后移术前为（11.7±1.7）mm，术后为（2.7±1.3）mm，均有显著性差异（P<0.05）。术后患侧膝关节前后方向的松弛情况通过KT-1000进行测量，平均为（2.4±1.2）mm，15例患者<3mm，3例患者>5mm。结论通过自体的腘绳肌腱经双股骨隧道对PCL的后交叉韧带进行重建， PCL的前外束及后内束均得以重建，与PCL的生理解剖结构相符，可以使关节功能得到良好恢复。
대관절경하자체객승기쌍고골수도중건후교차인대적근기림상료효진행관찰화분석。방법선택20례후교차인대（posterior cruciate ligament，PCL）손상도위3급적환자。통과자체객승기건쌍고골수도화단경골수도적방법대PCL중건。술전굴슬활동도위（120.5±3.8）°。환자수방18~30개월,평균25개월。결과수술후환자굴슬적활동도위（117.3±2.7）°，상비우술전몰유현저성차이（P>0.05），몰유출현신슬수한，차측반시험결과도시음성。환자술후적후추체시험결과위（1.3±0.5）°，Lysholm적술전평분위（50.6±7.2）분，술후평분위（93.2±2.8）분，Tegner술전평분위（1.3±0.6）분，술후평분위（6.2±0.8）분。경골후이술전위（11.7±1.7）mm，술후위（2.7±1.3）mm，균유현저성차이（P<0.05）。술후환측슬관절전후방향적송이정황통과KT-1000진행측량，평균위（2.4±1.2）mm，15례환자<3mm，3례환자>5mm。결론통과자체적객승기건경쌍고골수도대PCL적후교차인대진행중건， PCL적전외속급후내속균득이중건，여PCL적생리해부결구상부，가이사관절공능득도량호회복。
Objective To observe and analyse recent efficacy of arthroscopically autologous hamstring double femur tunnel reconstruction posterior cruciate ligament. Methods 20 cases of posterior cruciate ligament trauma Ⅲ were selected. Posterior cruciate ligament was reconstructed by arthroscopically autologous hamstring double femur tunnel and single tibia. Pre-operative knee flexion was (120.5±3.8)°. Patients were followed up for 18~30 months. Results Postoperative knee flexion was (117.3±2.7)°, there was no significant difference compared with preoperative (P>0.05). Knee extension limited did not appear. The result of side plates test was negative. The result of postoperative drawer test was (1.3±0.5)°. Preoperative Lysholm grade was (50.6±7.2) and postoperative was (93.2±2.8). Preoperative Tegner was (1.3±0.6) and postoperative was (6.2±0.8). Preop-erative tibial shift was (11.7±1.7)mm and postoperative was(2.7±1.3)mm,there was significantly difference(P<0.05). Affected side was determined by KT-1000,the average length was (2.4±1.2)mm, the length of 15 patients was shorter than 3mm,while 3 cases was longer than 5mm. Conclusion By arthroscopically autologous hamstring double femur tunnel reconstruction poste-rior cruciate ligament, anterolateral beams and posteromedial beams of PCL were constructed, and were consistent with physio-logical and anatomical structure of PCL, joint function get good recovery.