中国内镜杂志2025，Vol.31Issue(5)：12-20,9.DOI:10.12235/E20240275
自体腘绳肌腱移植重建前交叉韧带的关节镜下二次探查(附514例报告)
Second-look arthroscopic findings after anterior cruciate ligament reconstruction using hamstring tendon autograft(514 cases)
摘要
Abstract
Objective To evaluate the clinical outcomes of 514 cases of anterior cruciate ligament(ACL)reconstruction using hamstring tendon autograft and to observe postoperative changes and recovery of the grafts through second-look arthroscopy.Methods This retrospective study collected data from 514 patients who underwent ACL reconstruction with hamstring tendon autograft between May 2015 and June 2018,with a follow-up of at least one year.Knee function recovery and stability were assessed using the Lysholm score,International Knee Documentation Committee(IKDC)score,and Tegner score,along with the pivot shift test and Lachman test.During the second-look arthroscopy,key observations included the synovial coverage,continuity of the reconstructed ligament,and any intra-articular abnormalities.Results The time interval between ACL reconstruction and second-look arthroscopy ranged from 12 to 28 months,with an average of 20 months.Postoperative infection occurred in 2 cases,both of which were successfully treated with arthroscopic debridement and drainage.No other patients experienced infections,graft resorption,or other complications.At the second-look arthroscopy,the Lysholm score significantly improved from(43.56±9.89)preoperative to(92.21±6.12)postoperatively,the difference was statistically significant(P<0.05);The IKDC score increased from(20.32±7.87)to(85.67±10.43),the difference was statistically significant(P<0.05);The Tegner score improved from(4.31±0.82)to(6.61±1.21),the difference was statistically significant(P<0.05).Second-look arthroscopy revealed that the ligament remained intact in 375 patients,with partial tears in 139 patients,ligament tension was maintained in 447 patients,while 67 patients had laxity,the reconstructed ACL graft was deemed to be in good condition in 435 patients and suboptimal in 79 patients,there were significant differences observed in pre-and post-pivot shift test and Lachman test(P<0.05);Among the 514 patients,188(36.58%)successfully returned to sport.Conclusion ACL reconstruction using hamstring tendon autograft effectively restores knee function and stability.In patients followed for more than one years,the grafts show good vascularization and synovial coverage.Emphasis should be placed on systematic postoperative rehabilitation to optimize recovery.关键词
关节镜/前交叉韧带(ACL)/自体腘绳肌腱/二次探查Key words
arthroscope/anterior cruciate ligament(ACL)/hamstring tendon autograft/second-look分类
医药卫生引用本文复制引用
李炎烨,卢明峰,赵立连,许挺,邢基斯,李世林,严素敏,何利雷..自体腘绳肌腱移植重建前交叉韧带的关节镜下二次探查(附514例报告)[J].中国内镜杂志,2025,31(5):12-20,9.基金项目
佛山市"十四五"医学培育专科项目(No:FSPY145204) （No:FSPY145204）
广东省卫生健康委项目(No:A2022081) （No:A2022081）
