前交叉韧带合并外侧半月板损伤一期重建修复△

Simultaneous arthroscopic reconstruction and repair for anterior cruciate ligament tear complicated with lateral meniscus radial tear

摘要:

［目的］探讨前交叉韧带（anterior cruciate ligament, ACL）断裂合并外侧半月板放射状裂（lateral meniscus radial tear, LMRT） 一期镜下重建修复的疗效。［方法］ 2019 年 1 月 1 日—2020 年 12 月 30 日，对 14 例 ACL 断裂合并 LMRT 的患者采用镜下 I.D.E.A.L 股骨止点定位自体肌腱重建 ACL，同时对 LMRT 缝合治疗。分析围手术期、随访及影像结果。［结果］14 例患者均顺利完成手术，无感染、无神经血管损伤等并发症发生。患者平均随访时间 （16.80±2.31）个月，随时间推移， Lysholm 和 IKDC 评分、膝 ROM 均显著增加 （P<0.05）；Lachman 试验、前抽屉试验、外侧回旋挤压试验、轴移试验均显著改善 （P< 0.05）；影像 K-L 分期无变化 （P>0.05）。［结论］ 对 ACL 断裂合并 LMRT 采用镜下 I.D.E.A.L 股骨定位重建 ACL 和水平褥式加垂直褥式缝合外侧半月板放射状撕裂疗效满意。

Abstract:

[Objective] To investigate the clinical efficacy of simultaneous arthroscopic reconstruction and repair for anterior cruciate ligament (ACL) rupture combined with lateral meniscus radial tear (LMRT) . [Methods] From January 1, 2019 to December 30, 2020, 14 patients received arthroscopic ACL reconstruction with I.D.E.A.L femoral insertion positioning and tendon autograft, and LMRT suture treatment for ACL rupture complicated with LMRT. The consequences regarding to perioperative period, follow-up and images were ana- lyzed. [Results] All the 14 patients were successfully operated on without infection, neurovascular injury and other complications. With time of follow-up lasted for (16.80±2.31) months, the Lysholm and IKDC scores, as well as knee range of motion (ROM) significantly in- creased (P＜0.05) , moreover, the presentations in terms of Lachman test, anterior drawer test, McMurray test and pivot shift test significant- ly improved (P＜0.05) . However, the Kellgren -Lawrence grade for osteoarthritis remained unchanged at the latest follow- up (P＞0.05) . [Conclusion] Arthroscopic ACL reconstruction with I.D.E.A.L femur positioning and horizontal mattress plus vertical mattress suture for lateral meniscus radial tear are effective for ACL rupture complicated with LMRT,.