急性膝前交叉韧带损伤的关节镜治疗临床研究

摘要

目的 探讨利用膝关节镜技术早期重建前交叉韧带的临床效果.方法 本组自2010年3月~2012年3月应用关节镜治疗急性前交叉韧带损伤重建69例,男性67例,女性2例;年龄18~42岁,平均27.8岁.术前根据X线及MRI等影像学检查,先行膝关节镜检查、清除关节内积血、处理半月板损伤等关节内结构损伤.对完全断裂的前交叉韧带应用自体肌腱进行重建.术后辅助铰链式膝关节支具外固定进行系统功能康复锻炼.结果 本组69例术中镜下证实前交叉韧带股骨侧止点处撕裂47例,体部断裂22例.随访时间12~48个月,平均16.5个月.手术切口均甲级愈合,未出现感染.膝关节功能Lysholm评分术前为(51.5±5.1)分,术后12个月为(91.3±4.3)分,差异比较具有统计学意义(P<0.05).结论 关节镜下早期手术重建前交叉韧带损伤可明确关节内合并损伤,缩短治疗过程.%Objective To explore the clinical effect of arthroscopic treatment for anterior cruciate ligament (ACL) reconstruction.Methods From Mar.2010 to Mar.2012,69 cases (67 males and 2 females) of acute ACL ruptures were performed reconstruction surgery,with an average age of 27.8 (range;18-42)years.According to preoperative X-ray and MRI imaging examination,we performed arthroscopic examination,removed hemorrhage in joints,processed meniscus tears and reconstructed ACL through autogenous hamstring.Hinged long leg brace was used for rehabilitation practice.Results Arthroscopic findings were as follows: proximal ACL ruptures at femoral footprints in 47 cases and ACL body ruptures in 22 cases.All patients were followed up for 12-48 months (mean,(16.5±8.2)months).Incision healed well and no infection was found.Preoperative Lysholm score was 51.5±5.1 and significantly different compared with postoperative of 91.3±4.3 (P<0.05).Conclusion Early arthroscopic reconstruction of ACL can clear intra-articular injury,shorten the treatment process,and meet the standard of treatment specification.It is worthy to be promoted in clinical application.