摘要
目的：评估采用Ⅰ期关节镜辅助下重建前后交叉韧带（ACL/PCL）及修复膝后内侧韧带结构的方法,治疗膝关节后外侧脱位的临床效果.方法：自2008年3月至2012年8月,收治膝关节后外侧脱位22例.男16例,女6例;年龄20～53岁,平均30.5岁;运动伤8例,车祸伤5例,摔伤9例.前交叉韧带重建均使用自体半腱肌、股薄肌肌腱;后交叉韧带重建使用LARS人工韧带14例,自体半腱肌、股薄肌肌腱8例;膝后内侧韧带结构损伤行缝合修复17例,行自体半腱肌加强术5例;手术均为Ⅰ期完成.术后早期行CPM及主动活动训练.采用国际膝关节文献委员会IKDC分级及Lysholm评分评估疗效.结果：术后患者均获随访,时间11～56个月,平均39个月.术后膝关节IKDC评定：A级9例,B级10例,C级3例;末次随访IKDC评分89.6±3.1.末次随访Lysholm评分90.7±1.8,术后较术前评分改善.结论：关节镜下Ⅰ期重建前后交叉韧带及修复其他膝后内侧韧带结构,并辅以积极功能锻炼,能较好恢复关节稳定性,临床效果满意,是治疗膝后外侧脱位的一种有效方法.
Objective：To evaluate clinical outcomes of anterior cruciate ligament （ACL） and posterior cruciate ligament （PCL） reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.Methods：From March 2008 to August 2012,22 patients （16 males and 6 females,ranging in age from 20 to 53 years old,with an average of 30.5 years old） with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL,combined with the repair of injuries in the posteromedial complex and soft-tissue.Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down.The ACL was reconstructed using the gracilis and semitendinosus tendons.The PCL was reconstructed using LARS artificial ligaments （14 cases）,or gracilis and semitendinosus tendons （8 cases）.Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients.Continuouspassive montion （CPM） and active exercises were executed after operation at early stage.The IKDC and Lysholm system were used to evaluate therapeutic effects.Results：All the patients were regularly followed up,and the duration ranged from 11 to 56 months （averaged,39 months）.According to the IKDC scale,9 patients got a grade A result,10 got a grade B result,and 3 got a grade C result.The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up,which were both better than those before operation.Conclusion：Reconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.
出处
《中国骨伤》
CAS
2014年第8期686-690,共5页
China Journal of Orthopaedics and Traumatology
关键词
关节镜
创伤和损伤
膝关节
脱位
Arthroscopes
Wounds and injuries
Knee joints
Dislocations
