【作者】 赵统海；

【导师】 曹力；

【作者基本信息】 新疆医科大学 ， 骨科学， 2007， 硕士

【摘要】 目的:设计关节镜下利用股四头肌腱—髌骨块嵌入挤压固定方法重建后交叉韧带(PCL),观察其治疗PCL损伤的疗效。方法:自2002年6月～2006年12月,对33例PCL损伤患者采用关节镜下利用股四头肌腱—髌骨块嵌入和可吸收螺钉。挤压固定方法重建后交叉韧带。股四头肌腱移植物的获取中保证髌骨上极和股四头肌腱条的连接;股骨隧道制作好以后;股四头肌腱移植后将与之连接的髌骨块拉紧嵌入股骨隧道并用可吸收螺钉挤压固定,胫骨隧道内用可吸收螺钉挤压固定移植肌腱,并将牵引线捆绑于螺丝钉固定于胫骨上。治疗效果采用Lysholm评分和国际膝关节文献委员会(IKDC)的分级标准评定。结果:所有患者获得3～37个月(平均19个月)随访,无患者发生血管神经损伤及移植物失败等严重并发症。所有患者均无膝关节不稳定症状,除2例患者剧烈活动后关节疼痛外,其余患者关节疼痛症状明显缓解。Lysholm评分术后高于术前,差异有显著性意义(P＜0.01);IKDC评定结果明显优于术前。结论:采用股四头肌腱移植物对取材部位无不良影响,移植物生物力学特性更接近PCL,且可以切取任意长度和宽度,保证远大于PCL的强度.移植物固定采用本设计的骨块嵌入和可吸收螺钉挤压的方法,成功率高、并发症少,有明显优越性。更多还原

【Abstract】 Objective:To discuss the design of arthroscopic reconstruction of posterior cruciate ligament(PCL)with quadriceps tendon fixed by a patellar block,and its clinical outcome.Methods:Thirty-threes patients suffering from PCL injury were treated by the technique mentioned above.The connection between quadriceps tendon and superior patellar pole was preserved in the havest process of quadriceps tendon,the femoral tunnel was a small tunnel,about 10～11mm wide,which was clogged with the patellar bone block.The quadriceps tendon strip was fixed by an absorble screw into the tibial tunnel. their functional recovery,was evaluated by Lysholm scoring and IKDC(International Knee Documentation Committee)criteria.Results:In the average follow-up period of 19 months,there were not any severe nerve or blood vessel lesions,or failures of transplanted ligament.None of the patents complained of knee instability after the opration.The pain was relieved in most patients,but three complained of pain after knee movement.A little calcification was found in the quadriceps tendon at the superior patellar one year after the opration in the X-ray of a patient,three was significant difference in Lysholm scale between pre-opration and post-opration(p＜0.01).their IKDC evaluation before opration significantly improved after opration.Conlusions:quadriceps tendon harvest may have little influence on the donor area.And quadriceps tendon is similar to PCL in biomechanics and can be harvested in any length and width needed so as to provide more strength than PCL.As a result,arthroscopic PCL reconstruction with quadriceps tendon fixed by a patellar block can be done with a high success rate and few complication.更多还原