目的 探讨一期关节镜下重建前后交叉韧带和修补内侧副韧带的临床疗效。方法 回顾性分析2012年7月—2017年7月收治的32例前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)断裂、内侧副韧带(medial collateral ligament,MCL)上止点Ⅲ度损伤患者,男21例,女11例;年龄21～53岁,平均(33±8.4)岁;受伤到手术时间为16~21 d,平均(19±1.9) d,一期关节镜下同种异体肌腱重建PCL、自体肌腱(半腱肌,或和股薄肌)重建ACL;锚钉修补MCL。 结果 27例患者术后随访6～32个月,平均(18±7.8)个月,末次随访行轴移试验均阴性,Lysholm 评分、Tegner 评分及IKDC 主观评分明显改善,膝关节活动度正常。结论 一期关节镜下前、后交叉韧带重建和内侧副韧带修补具有治疗周期短,能早期功能锻炼,有效恢复膝关节稳定性等优点,临床治疗效果满意。
Objective To explore the clinical effects of one-stage anterior and posterior cruciate ligament reconstruction under arthroscopy combined with medial collateral ligament repair.Methods From July 2012 to September 2017, 32 patients with anterior cruciate ligament (ACL) injury, posterior cruciate ligament (PCL) injury, and grade 3 medial collateral ligament (MCL) injury were treated.They were 21 males and 11 females, with an average age of 33±8.4 (21 to 53) years old.The average time from injury to operation was 19±1.9 (16 to 21) days.The ACL and PCL were reconstructed under arthroscopy with autologous tendon and allogeneic tendon, and the upper stop rupture of MCL was repaired with anchors.Results The 27 patients were followed up for an average of 18±7.8 (6 to 32) months.At the last follow-up, the Lysholm score, Tegner score and the International Knee Documentation Committee (IKDC) rating were significantly improved.All the patients showed a negative pivot shift test result and a normal range of motion.Conclusion One-stage reconstruction of ACL and PCL under arthroscopy combined with MCL repair can effectively restore the function of the knee joint and lead to satisfactory clinical outcomes on account of its shorter treatment cycle and early functional exercise.
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