Objective To study the operative techniques and clinica effect of arthroscopic reconstruction of posterior cruciate ligament with ligament advanced reinforcement system Y - shape douhle bundles artificial ligament. Methods From June 2006 to August 2010 ,14 patients with PCL rupture were treated with LARS under arthroscopic ohservation. There were 10 males and 4 females , aged 19 ～ 58 years old. The left knee were involved in 5 cases and the right knee in 9 cases. The time from injury to reconstruction was 10 ～30 days( 15. 7 days on average ). The main causes of injuries were sports in 9 cases ,falling in 2 cases and traffic accident in 3 cases. There were 5 cases with associated medial meniscus injury and 3 cases with lateral meniscus injury. MRI showed 14 cases with PCL completly rupture and 2 cases with ACL completely rupture were found.1 case caused by traffic accident with fracture was found. The preoprative lysholm score was 20～55( 40. 0 ±8. 1 on average ). The operation was perfomed under arthroscopic observation. The tihial isometric point and tunnel were drilled with the help of a drill bit guide, while the femoral isometric and tunnel were drilled under C - arme X - ray machine. Results All the patients were regularly followed up for 6 ± 60 months( 20. 5months on average ) , The postoperative lysholm score was 84 - 93( 88. 1 ± 3 . 3 on average ). There was a significant difference hetween preoperation and postoperation. Complication such as infection ,spontaneous rupture or laxity of graft were not observed. Conclusion The short - medium term clinical effect of PCl arthroscopic reconstruction with the use of LARS artificial ligaments were satisfactory. The recovery of knee stability was good and rapid , avoiding the use of autologous of tendon reconstruction of the material had to compication , Materials to avoid allograft rejection and infection complication.Its operation is simple, short operation time , minimally invasive surgery and postoperative joint quick restore.%目的 探讨在关节镜下应用韧带增强重建系统(LARS)人工韧带重建膝关节后交叉韧带(PCL)的手术技巧及临床疗效.方法 2006年6月至2010年8月年采用关节镜下LARS人工韧带重建PCL断裂14例患者,男性10例,女性4例,年龄19～58岁,左侧5例,右侧9例,病程10 d～1个月,平均15.7 d,致伤原因:运动扭伤 9例,摔伤2例,车祸3例,磁共振成像(MRI)示:PCL完全撕裂直接征象14例,前交叉韧带(ACL)完全撕裂直接征象2例,合并内侧半月板损伤5例,合并外侧半月板损伤3例,其中1例车祸伤合并髋臼后壁骨折,按照Lysholm膝关节功能评分:20～55分,平均(40.0±8.1)分.治疗在关节镜下完成,PCL的胫骨止点、隧道用定位器完成;股骨止点、隧道在C臂X线机下完成.结果 本组所有患者伤口均为I甲愈合,术后无慢性滑膜炎、韧带断裂、韧带松动、活动明显受限等并发症,所有患者均获随访,随访时间 6～60个月,平均20.5个月,Lysholm膝关节功能评分:84～93分,平均(88.1±3.3)分,与术前比较差异有显著性(P<0.05).结论 在关节镜下运用 LARS人工韧带重建膝PCL近中期疗效好,有效恢复了膝关节稳定性,避免了采用自体肌腱重建取材的并发症,也避免了同种异体肌腱移植材料的排斥及传染疾病的并发症,其手术操作简便,创伤小,康复快.
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