摘要
目的:观察关节镜下应用LARS人工韧带重建后交叉韧带患者的膝关节功能恢复情况。方法:选择2005-01/2006-05在南方医科大学附属花都医院骨科行关节镜下LARS人工韧带重建的复杂后交叉韧带损伤患者6例,术前均知情同意并签字。所有重建手术均为二期手术。①先建立胫骨骨隧道。②然后建立股骨骨隧道。③关节镜监视下,将LARS人工韧带的“Y”形双束穿出前外与前内束股骨双隧道,分别于屈膝90°和30°位拉紧固定。术后3d开始被动活动,1周后行股四头肌主动锻炼。术后定期随访,膝关节功能评估采用Lysholm评分标准,包括8个方面:跛行、支撑、交锁、不稳、疼痛、肿胀、上下梯及下蹲。总分100分,分数愈高,膝关节功能恢复愈好。结果:6例患者均获得随访,无一例脱落,随访时间分别为7,7,10,10.4,12.8,14个月,平均10.2个月。所有患者术后膝关节不稳定症状消失,胫骨后坠征阴性,后抽屉试验阴性。患者术后的膝关节Lysholm功能评分显著高于术前(83.5±4.5,51.6±3.6,P<0.01)。结论:关节镜下LARS人工韧带重建后交叉韧带可以更好地恢复膝关节的稳定性,且创伤小,并发症少,疗效满意。
AIM： To observe the functional recovery of knee joint in patients with posterior cruciate ligament （PCL） under knee arthroscopy with ligament advanced reinforcement system （LARS） artificial ligament transplantation.
METHODS： From January 2005 to May 2006, six patients with PCL injury treated by reconstruction of PCL with LARS artificial ligament transplantation ware selected from the Department of Orthopedics, Huadu Hospital Affiliated to Southern Medical University. All subjects agreed with the operation before the surgery and all reconstruction surgeries ware of second period.① The tibial tunnel was established firstly. ② Then was the femoral tunnel. ③ Under knee arthroscopy, the ＂Y＂-shape double cords of LARS artificial ligament were cut through ante-out and meta-in bone tunnels of femur, and fixed at 90o and 30o flexion respectively. Patients were required to motor 3 days postoperative, and patients actively exercised their quadriceps muscle of thigh at one week later. Regular follow-ups were conducted postoperatively, and functional evaluation of the knee joints was performed by according to Lysholm standards, including 8 aspects： Limping, supporting, interlocking, unstable, painful, swell, upstairs and downstairs and squatting with a total score of 100 points. The higher the score was, the better the functional recovery of knee joint.
RESULTS： All of the 6 patients were available at follow-up, and no one withdrew from the study. The follow-up was conducted at the T^th, T^th, 10^th, 10.4^th, 12.8^th, and 14^th months with an average duration of 10.2 months. After operation, unstable symptoms of knee joint in all subjects disappeared with negative sag sign and posterior drawer. The Lysholm knee scores of patients postoperation ware significantly higher than those before the surgery （83.5±4.5, 51.6±3.6, P〈 0.01）.
CONCLUSION： Under knee arthroscopy, the reconstruction of PCL with LARS artificial ligament transplantation can regain stabilization of knee joint, and it can
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第8期1550-1551,F0003,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
