| 引用本文： |
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陆叶,蒋仕林,袁锋.经胫骨隧道前交叉韧带双束八股解剖重建的临床研究[J].同济大学学报（医学版）,2022,43(3):380-387. [点击复制]
- LU Ye,JIANG Shilin,YUAN Feng.Clinical study of anatomical double-bundle ACL reconstruction with eight strands through the tibial tunnel[J].同济大学学报（医学版）,2022,43(3):380-387. [点击复制]
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| 摘要: |
| 目的观察关节镜下采用自体腘绳肌腱经胫骨隧道前交叉韧带（anterior cruciate ligament, ACL）双束八股解剖重建的临床效果。方法随访上海交通大学附属第六人民医院运动医学科2018年12月—2020年1月收治的103例ACL断裂患者资料，其中男78例，女25例，年龄18~45岁，平均（26.8±5.86）岁；左侧47例，右侧56例，均采用关节镜下自体腘绳肌腱经胫骨隧道打股骨骨隧道，ACL双束八股解剖重建。按照Lysholm评分、国际膝关节评分委员会（IKDC）膝关节评分、Tegner膝关节评分标准和膝关节自我效能量表K-SES评价疗效。结果所有患者术后获随访12～42个月，平均（24±8.18）个月；手术前、末次随访评分比较，Lysholm评分分别为（48.41±4.44）分和（95.34±1.91）分，2组比较差异有统计学意义（P<0.001)；IKDC评分分别为（44.05±4.36）分和（95.66±1.89）分，2组比较差异有统计学意义（P<0.001)；Tegner评分分别为（2.84±0.95）分和（6.15±0.89）分，2组比较差异有统计学意义（P<0.001)；膝关节自我效能量表K-SES量表（3.10±0.83）分和（7.12±1.10）分，2组比较差异有统计学意义（P<0.001)。末次随访103例患者前抽屉试验阴性，轴移试验阴性。98例（95.1%）Lachman试验阴性，5例（4.9%）Lachman试验1°阳性。结论关节镜下采用自体腘绳肌腱经胫骨隧道双束八股解剖重建前交叉韧带是一种恢复膝关节稳定性，恢复伤前活动水平的有效方法。 |
| 关键词: 前交叉韧带 解剖重建 双束 八股 |
| DOI：10.12289/j.issn.1008-0392.21400 |
| 投稿时间：2021-09-22 |
| 基金项目:上海市卫生健康委员会课题（201940427）；上海市科委课题（20Y11913300）；上海申康医院发展中心临床科技创新项目（SHDC12020118） |
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| Clinical study of anatomical double-bundle ACL reconstruction with eight strands through the tibial tunnel |
| LU Ye,JIANG Shilin,YUAN Feng |
| (Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China) |
| Abstract: |
| ObjectiveTo evaluate the clinical effect of arthroscopic anatomical reconstruction of the anterior cruciate ligament（ACL) through the tibial tunnel with autologous hamstring tendon. MethodsClinical data of 103 patients with ACL rupture admitted to our department from December 2018 to January 2020 were enrolled in the study. There were 78 males and 25 females with a mean age of (26.8±5.86) years （18 to 45 years); the rupture on the left side in 47 cases and on the right side in 56 cases. All patients underwent arthroscopic anatomical double-bundle ACL reconstruction with eight-strands autogenous hamstring tendon through the tibial tunnel. According to Lysholm, International Knee Score Committee（IKDC) Knee Score, Tegner Knee Score and Knee Self-Efficacy Scale（K-SES）, the curative effect was evaluated. ResultsAll patients were followed up for 12 to 42 months with an average of (24±8.18) months. There were significant differences in the Lysholm, IKDC, Tegner and K-SES scores before the operation and in the final follow-up： the Lysholm scores were decreased from （48.41±4.44) before operation to （95.34±1.91) in the final follow up（P<0.001); the IKDC scores increased from （44.05±4.36) points to （95.66±1.89) points（P<0.001); the Tegner scores increased from （2.84±0.95) points to （6.15±0.89) points（P<0.001); the K-SES increased from （3.10±0.83) points to（7.12±1.10) points（P<0.001). At the last follow-up, 103 patients had negative anterior drawer test and negative pivot shift test. 98 cases（95.1%) were negative in Lachman test, and 5 cases（4.9%) were one-degree positive in Lachman test. ConclusionArthroscopic anatomical double-bundle ACL reconstruction with eight-strands autogenous hamstring tendon through the tibial tunnel is a reliable method to restore the stability of the knee joint and enable individuals to return to their prior activity level. |
| Key words: anterior cruciate ligament anatomical reconstruction double bundle eight-strands |
