摘要
目的介绍以自体骨髌腱骨重建膝关节后交叉韧带的方法并评价其对治疗膝关节后不稳定的临床效果。方法采用膝前方入路，经胫骨股骨等长点骨隧道植入自体髌腱重建后交叉韧带（ＰＣＬ），治疗陈旧性ＰＣＬ断裂所致慢性膝关节不稳病例２０例。采用Ｌａｒｓｏｎ膝关节功能评分、患者主观评价和膝关节稳定性检查评价其临床疗效。结果２０例患者术前Ｌａｒｓｏｎ评分平均６２分，术后经６～５８个月随访，平均评分达９２分，１８例主观评价满意；Ｌａｃｈｍａｎ试验全部转为阴性，膝关节活动度平均为１１５度。结论此手术方法可以提供足够强度和稳定的ＰＣＬ替代，但手术操作较前交叉韧带（ＡＣＬ）重建困难。可能影响手术疗效的因素包括：术前对关节不稳的评价、移植物的准备以及内固定、ＰＣＬ的等长植入、其他附属结构的修复与重建及术后移植物的张力等。
Objective To introduce the surgical procedures of posterior cruciate ligament (PCL) reconstruction using bone patellar tendon bone autograft and to evaluate the clinical effect of treatment of posterior instability. Methods Twenty cases of chronic instability of knee secondary to rupture of PCL underwent reconstruction of PCL using free autograft of bone patellar tendon bone by isometric tibial and femoral attachment through anterior approach of knee.Larson knee function score,patient subjective evaluation and physical testing were used to evaluate the effect of this procedure. Results In this series,the average point of Larson score was 62 preoperatively. By the period of 6 58 month follow up,the average point was 92. Subjectively 18 cases showed satisfactory results. Lachmann test showed negative results in all cases. The range of motion was 115 degrees on the average. Conclusions This method can provide a strong and stable PCL replacement.But the surgical procedure is more difficult than ACL reconstruction. Some factors for a successful operation include evaluation of instability,preparation of graft material,internal fixation of graft,isometric attachment, reconstruction of other structures of knee,and bearing tension of graft.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第2期93-95,共3页
Chinese Journal of Surgery
关键词
后交叉韧带
膝关节
外科手术
PCL
Posterior cruciate ligament Knee joint Surgry,operative
