Objective To investigate the effect of single bundle anatomic reconstruction of the anterior cruciate ligament (ACL) with the hamstring autograft through anteromedial approach. Methods From January 2012 to Jan-uary 2014, 39 patients with ACL tore had been treated with single bundle anatomic ACL reconstruction with the hamstring autograft. In this group, 20 males and 19 females, 16 cases of the left knee and 23 cases of the right knee;including 27 cases of sports injuries, 5 cases of traffic accident injury and 7 cases of fall injury.8 cases were acute injury the others were old injury. 22 cases were had the meniscus injury. All patients were treated with single bundle anatomic ACL reconstruction with the hamstring autograft. The femoral tunnel was establish through the anteromedial approach. The medial meniscus suture was performed in 10 cases, partial resection in 2 cases, lateral meniscus su-ture in 9 cases, partial resection in 1 cases. The hamstring autograft was fixed with the RIGFIX system in the femoral tunnel and the BIOSURE SYNC in the tibia tunnel. The Lysholm score was used to evaluate the recovery of knee function, and the MRI score was used to evaluate the integraty of the grafts. Results All cases were followedup for 15 to 39 months with an average of 21.5 months. All cases had no vascular nerve injury, joint stiffness, infec-tion and other complications. All cases had good stability after 1 year and recover to normal sports after six months and intense sports after half past a year postoperation. The anterior drawer test and the Pivot shift tests were negative in all patients. The Lacheman test wasⅠin 1 patient and others were negative. The mean Lysholm score was (93.85± 4.33) which significantly increased compared with preoperative scores which was (36.84 ± 5.60) after 15 months (P <0.05). The MRI showed good maturity and normal morphology of the ACL autograft, the MRI score was (9.80 ±1.70) after 1 year postoperation. Conclusion The arthroscopic single bundle individual anatomic ACL reconstruction with hamstring autograft through anteromedial approach is effective, simple to perform and gives a graft the same as nor-mal anatomy. The grafts revascularization is good and effectively restore the stability of the knee.%目的 探讨关节镜下经前内侧入路个体化解剖重建前交叉韧带(ACL)的效果.方法 2012年1月-2014年1月,39例ACL损伤患者.其中,男20例,女19例;左膝16例,右膝23例;其中运动损伤27例,车祸伤5例,摔伤7例;8例急性损伤,31例陈旧性损伤,合并半月板损伤22例.所有患者均采用关节镜下自体腘绳肌肌腱解剖点重建ACL,经前内侧入路建立股骨隧道.内侧半月板缝合10例,部分切除2例,外侧半月板缝合9例,部分切除1例.股骨侧用强生公司RIGFIX横穿钉固定,胫骨侧用施乐辉公司胫骨固定翼系统固定.用Lysholm膝关节功能评分评价功能恢复情况,磁共振成像(MRI)评分评价移植物体内完整性.结果 所有病例随访15~39个月,平均21.5个月.所有病例均未发生血管神经损伤,关节僵硬,感染等并发症.术后1年时所有病例均感膝关节稳定性良好,术后半年开始恢复一般体育运动,术后1年半时恢复对抗性体育运动.术后前抽屉试验均阴性,Lacheman试验Ⅰ度阳性1例,余阴性.轴移试验均阴性.术前Lysholm评分为(36.84±5.60)分,术后15个月时为(93.85±4.33)分,术前术后差异有统计学意义(P<0.05).术后1年时复查MRI见移植物成熟度良好,形状与ACL形态相符,MRI评分为(9.80±1.70)分.结论 经前内侧入路个体化解剖重建ACL,移植物形态与正常解剖相同,移植物成熟良好,可有效的恢复膝关节稳定性.
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