单隧道双束腘绳肌腱双Intrafix固定重建前交叉韧带近期疗效观察

目的 探讨单隧道双束腘绳肌腱双Intrafix固定重建前交叉韧带(ACL)中应用的可行性及近期疗效.方法 对30例ACL损伤患者行关节镜下单隧道双束腘绳肌腱ACL重建术.采用膝关节镜前内侧入路(AM)建立股骨隧道,胫骨端用点对点ACL瞄准器建立隧道.隧道股骨端采用Femoral-Intrafix固定将腘绳肌腱分为前内侧束及后外侧束.通过旋转胫骨端移植物,将移植物调整为生理的双束位置,采用Bio-Intrafix固定胫骨端.结果 30例均获随访,时间6～8个月.根据Lysholm膝关节功能评分:术前为19～58(33.17±11.71)分;术后6个月为88～98(95.30±2.10)分(t=30.20,P<0.01).结论 单隧道双束腘绳肌腱双Intrafix固定重建ACL,手术操作简便,固定牢固,近期效果满意.

Application of double Intrafix fixation in single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendons

Objective To study the feasibility and short-term effects of double Intrafix fixation in single-tunnel double-bundle anterior cruciate ligament(ACL) reconstruction with anatomical placement of hamstring tendons autograft.Methods Arthroscopic ACL reconstruction was carried out in 30 patients with ACL injuries by using the quadruple hamstring tendon autograft.The femoral tunnel was placed at lateral femoral condyle at 2:00(left knee) or 10:00(right knee) position through the anteromedial(AM) portal with the knee flexed to 120° using an offset guide(DePuy Mitek).The tibia tunnel was placed at the center of the ACL remnant through the AM portal using a tibia guide set 45°.The AM and PL bundles were rotated by rotating the positioning tool to achieve the desired positions of the bundles and were fixed by femoral Intrafix and tibia Intrafix fixation.Results A follow-up check up was made in the 30 patients for 6~8 months.The Lysholm scores improved from a preoperative score of 19~58(33.17±11.71) to 88~98(95.30±2.10) at follow-up.There were significant difference in the Lysholm scores between preoperative group and postoperative group(t=30.20,P<0.01).No postoperative complications such as synovitis and ligament rupture and movement restriction occurred.Conclusions Double Intrafix fixation in single-tunnel double-bundle ACL reconstruction with anatomical placement of hamstring tendons autograft can be simple,effective,useful,reproducible and gives a satisfactory short-term results.