關(guān)節(jié)鏡下運(yùn)用lars人工韌帶重建膝前交叉韌帶

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1、關(guān)節(jié)鏡下運(yùn)用LARS人工韌帶重建膝前交叉韌帶作者：徐又佳，董啟榕，周海濱，陳海南，王向利，汪益，謝宗剛，茅泳濤，鄭祖根【摘要】［目的］探討在關(guān)節(jié)鏡下運(yùn)用“LARS人工韌帶”重建膝前交叉韌帶的手術(shù)方法和臨床療效。［方法］2006年6月起運(yùn)用法國LARS膝關(guān)節(jié)前交叉韌帶治療急性前交叉韌帶斷裂15例，男11例，女4例，年齡22～51歲（平均26.8歲）。所有患者術(shù)前Artoscan均提示前交叉韌帶連續(xù)信號中斷，膝關(guān)節(jié)Lysholm評分平均50分。治療在關(guān)節(jié)鏡下完成，股骨隧道口定位在外髁內(nèi)側(cè)面140°弓形弧的中心點(diǎn)，脛骨隧道口定位在平臺內(nèi)外側(cè)髁間嵴之間、髁間窩頂線后2～4mm

2、。骨隧道直徑為7.5mm、LARS韌帶直徑為8mm、空心擠壓螺釘直徑為8mm。［結(jié)果］經(jīng)平均18個月隨訪，術(shù)后Lysholm評分平均90分，優(yōu)8例，良5例，可2例，近期優(yōu)良率為86.6％。本組無術(shù)后感染、無韌帶自發(fā)斷裂、無韌帶松動并發(fā)癥。［結(jié)論］運(yùn)用“LARS人工韌帶”重建膝前交叉韌帶可達(dá)到解剖重建，可有效恢復(fù)膝關(guān)節(jié)穩(wěn)定性；關(guān)節(jié)鏡下手術(shù)擁有創(chuàng)傷小、康復(fù)快、療效好等微創(chuàng)特點(diǎn)?！娟P(guān)鍵詞】關(guān)節(jié)鏡；LARS人工韌帶；前交叉韌帶；重建術(shù)Abstract：［Objective］Toexploretheoperatingmethodsand14rudimentalclinicalef

3、fectsofreconstructionofanteriorcruciateligament(ACL)withtheligamentadvancementreinforcementsystem(LARS)artificialligamentsunderarthroscope.［Method］SinceJuneof2006,15patients（11malesand4females,withanaverageageof26.8years）withacuteACLrupturehavebeentreatedwiththeLARSartificialligaments.Th

4、eresultsofpreoperativeArtoscanofallpatientssuggesteddiscontinuationofACL.TheaveragescoreofLysholmonkneejointwas50points.Theoperationswerecompletedunderarthroscope.Bonetunnelsofthefemurwerelocatedatthecentralpointofarconthemedialsurfaceofectocondyleof140degree.Bonetunnelsoftibiawerelocat

5、edbetweenthemedialandlateralcondyleonthetibialplateau、2-4mmtosummitlineoffossaintercondylica.Thediameterofthebonetunnelswas7.5mmwhilethatofLARSligamentandhollowcrushingscrewwere8mm.［Result］All15patientswereavailableforfollowupwithanaverageof18months.Nopostoperativecomplicationssuchasinf

6、ection,ligamentrupture,ligamentlooseningoccurred.Theclinicalresultsweregradedasbeingexcellentin8patients,goodin5andfairin2accordingtotheLysholm'sclassification.Theexcellentandgoodratewas86.6%.［Conclusion］Theanatomicalreconstructionandthestability14ofthekneejointcanbeobtainedafterACLrecon

7、structionwithLARSartificialligaments.Theoperationunderarthroscopehasadvantagesoflessinjury,rapidrecoveryandsatisfactorycurativeeffect.Keywords：arthroscopy;LARSartificalligament;anteriorcruciateligament(ACL);reconstruction　　膝前交叉韌帶是膝關(guān)節(jié)穩(wěn)定的重要結(jié)構(gòu)之一，前交叉韌帶斷裂可引起脛骨與股骨相對移動，可發(fā)生脛骨伸直位