Objective To explore the clinical efficacy of reconstruction of posterior cruciate ligament(PCL) by autologous four strands of thin and half tendon under arthroscopy. Methods A retrospective study was conducted to select 32 patients with PCL injury underwent arthroscopic autogenous four - strand thin tendon and semitendinosus tendon reconstruction in Nanjing Hospital of Nanjing Medical University during August 2016 to September 2018. Difference in Lysholm scores and Tegner activity scores,difference in Lysholm test and drawer test results,difference in knee joint dysfunction at each time point (preoperative,postoperative 6 months,12 months and 24 months). Results The Lysholm scores (82. 37 ± 4. 69) after surgery were significantly higher than those before surgery (35. 75 ± 5. 26),and the difference was statistically significant (P ＜ 0. 05). The postoperative Tegner activity scores (6. 88 ± 2. 14) were significantly. higher than those before surgery (3. 47 ± 1. 76), and the difference was statistically significant (P ＜ 0. 05). Thirty - two patients were negative after surgery[Lachman test in 27 cases (84. 38％) ], degree I positive in 4 cases (12. 50％),degree II positive in 1 case (3. 13％) was positive; 29 cases (90. 63％) were negative after operation, and 3 cases (9. 38％) were positive with I degree; the clinical symptoms of knee joint were improved after operation (P ＜ 0. 05). The knee joint dislocation in 6 cases after operation in 6 months,12 months,and 24 months were (3. 95 ± 0. 41),(3. 71 ± 0. 32) °and (3. 39 ± 0. 28) °respectively, and the knee joint misalignment at each time point after surgery compared with those at preoperation (4. 82 ± 0. 22),the difference was statistically significant (P ＜ 0. 05). Conclusion Lysholm scores and Tegner activity scores were increased in patients with arthroscopic autogenous four strand semitendinosus tendon and gracilis tendon reconstruction,the joint fault dynamics was gradually reduced and the effect of operationt was more reliable.%目的 探讨关节镜下自体四股股薄半腱肌腱重建膝关节后交叉韧带(PCL)的临床疗效.方法 采用回顾性研究方法,选取2016年8月至2018年9月32例在南京医科大学附属南京医院骨科行关节镜下自体四股股薄肌腱和半腱肌腱重建术的PCL 损伤患者,比较患者手术前后Lysholm评分和Tegner 活动评分的差异、Lysholm 试验和抽屉试验结果 的差异、各时间点(术前、术后6 个月、术后12 个月、术后24 个月)膝关节错动感的差异.结果 患者手术后的 Lysholm评分(82.37 ± 4.69)分显著高于手术前(35.75 ± 5.26)分,且差异具有统计学意义(P ＜ 0.05);患者手术后的 Tegner 活动评分(6.88 ± 2.14)分显著高于手术前(3.47 ± 1.76)分,且差异具有统计学意义(P ＜ 0.05);32例患者手术后Lachman 试验阴性27例(84.38％),Ⅰ度阳性4例(12.50％),Ⅱ度阳性1例(3.13％);手术后抽屉试验阴性29例(90.63％),Ⅰ度阳性3例(9.38％);患者术后膝关节临床症状明显好转(P ＜ 0.05);患者手术后6 个月、12 个月、24 个月的膝关节错动感分别为(3.95 ± 0.41)°、(3.71 ± 0.32)°、(3.39 ± 0.28)°,术后各时间点的膝关节错动感与术前(4.82 ± 0.22)°比较,差异均具有统计学意义(P ＜ 0.05).结论 关节镜下自体四股股薄半腱肌腱重建术后患者的Lysholm评分和Tegner 活动评分提高,膝关节错动感逐渐降低,手术效果较可靠.
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