关节镜下自体胭绳肌腱重建前交叉韧带应用Rigidfix和Intrafix系统固定的价值

目的 探讨关节镜下自体胭绳肌肌腱单束重建前交叉韧带(ACL)时应用Rigidfix和Intrafix系统固定的临床效果.方法 2004年6月至2007年10月,40例ACL断裂的患者均在关节镜下采用4股胭绳肌肌腱单束重建ACL,股骨端移植物应用Rigidfix系统固定,胫骨端移植物应用Intrafix系统固定,术后进行系统的康复治疗.结果 所有患者均未发生严重并发症,术后进行6～12个月随访,膝关节屈曲均达到130°,伸直达到0°,随访时前抽屉试验35例阴性,5例Ⅰ度阳性,Lachman试验37例阴性,3例Ⅰ度阳性,轴移试验均为阴性,所有患者均无膝关节不稳的主观症状.术前及随访时前抽屉试验阳性率比较(100% vs.12.5%),差异有统计学意义(χ2=58.72,P＜0.01);术前及随访时轴移试验阳性率比较(82.5% vs.0),差异有统计学意义(χ2=52.82,P＜0.01).按照Lysholm膝关节评分标准,评分从(40.3±4.2)分提高至(90.4±3.6)分,差异有统计学意义(t=3.852,P＜0.01).结论 关节镜下自体胭绳肌肌腱重建ACL时应用Rigidfix和Intrafix系统固定是一种较好的方法,具有手术操作简单、固定牢固、愈合率高等优点,值得推广应用.

Arthroscopic reconstruction of anterior cruciate ligament with autogeneic hamstring tendons fixed by Rigidfix and Intrafix systems

Objective To explore surgical techniques and clinical effects of arthroscopic reconstruction of anterior eruciate ligament (ACL)with autogeneic hamstring tendons fixed by Rigidfix and Intrafix systems. Methods Forty patients with ACL rupture underwent arthruscopic ACL reconstruction with autografts of four-stranded hamstring tendon using Rigidfix and Intrafix system fixation. Systematic rehabilitation aft conducted post-operatively. Results Follow-ups of 6 to 12 months reve Med no serious complication in this group. The anterior drawer test was negative in 35 cases and I°positive in 5.The Lachman test Was negative in 37 cases and I° positive in 3.No patient reported unsteady knee joint. The average Lysholm knee score was 40.3±4.2 preoperatively and 90.4±3.6 postoperatively, with significant difference (P＜0.01). Conclusion Arthroscopic reconstruction of ACL with autogeneic hamstring tendons fixed by Rigidfix and Intrafix systems is effective because of benefits of limited invasion and satisfactory fixation and recovery of joint function.