骨道内移植物更合理分布的单隧道单束前交叉韧带重建的中期疗效观察

背景：骨道内移植物更合理分布的单隧道单束重建前交叉韧带（ACL）已被生物力学研究证实能够很好地恢复膝关节稳定性，短期随访效果明确，但缺乏中远期的临床随访观察研究。 目的：探讨关节镜下同种异体胫前肌腱骨道内移植物更合理分布的单隧道单束重建ACL的中期临床疗效。 方法：本组40例，均为男性，年龄18~35岁，平均（26.3±8.7）岁。均行关节镜下骨道内移植物更合理分布的单隧道单束同种异体胫前肌腱重建，并进行术后随访。采用IKDC评分、Lysholm膝关节功能评分，并进行麦氏征试验、抽屉试验、Lachman试验及轴移试验比较患者术前和术后的膝关节功能恢复情况和评分。 结果：40例全部获得随访，随访时间为24~48个月，平均（36.5±12.5）个月。术前麦氏征阳性8例，抽屉试验阳性27例， Lachman试验及轴移试验40例均阳性。术后上述4项试验均为阴性。术前后IKDC评分与Lysholm膝关节功能评分，均有统计学差异（P＜0.05）。 结论：关节镜下同种异体胫前肌腱骨道内移植物更合理分布的单隧道单束重建ACL的中期疗效满意。

Midterm clinical evaluation of modified single-tunnel single-bundle anterior cruciate ligament reconstruction

Background：Single-tunnel single-bundle anterior cruciate ligament （ACL） reconstruction can restore biomechanical func-tion, and the short-term clinical results are clear. But the clinical follow-up study is insufficient. Objective：To evaluate the midterm curative effects of single-tunnel single-bundle ACL reconstruction with anterior tibial tendon allograft. Methods：Forty male patients with an average age of （26.3±8.7） years （range 18-35 years） received single-tunnel single-bundle ACL reconstruction using anterior tibial tendon allograft, and were followed up. Preoperative and postoperative knee func-tion and ratings were compared by the IKDC score, Lysholm score, McMurray test, anterior drawer test, Lachman test and pivot-shift test. Results：The average follow-up period was （36.5 ± 12.5） months （range 24-48 months）. Before surgery, McMurray test was positive in 8 cases, anterior drawer test was positive in 27 cases, Lachman test and pivot-shift test were positive in all 40 cas-es. After surgery, however, the results of above four tests were negative in all patients. There were significant differences in IKDC score and Lysholm score before and after surgery （P＆lt;0.05）. Conclusions： Single-tunnel single-bundle ACL reconstruction using anterior tibial tendon allograft shows satisfying mid-term clinical results.