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目的：探讨应用无内固定装置技术双束双隧道重建前交叉韧带（ACL）的治疗效果。方法：2006 年1 月至2008 年1 月，我科应用无内固定装置技术双束重建ACL 损伤患者33 例，男31 例，女2 例。患者排除手术禁忌后，分别在关节镜下采用双股半腱肌腱重建前内侧束，双股股薄肌腱重建后外侧束。韧带采用无内固定装置固定，股骨端行悬吊固定，胫骨端行拴桩固定。术后1~3 周内指导患者在支具保护下进行康复训练，并逐渐提高训练强度。结果：术后切口均一期愈合，无并发症。病例随访时间24~48 个月，平均36 个月。术后12 月时：Lysholm 评分由术前的52.2±2.5，升至96.4±7.2 分，IKDC 评分55.3±3.7 分，升至94.1±5.3 分，其中A 级19 例，B 级：11 例。术前与术后Lysholm 评分及IKDC 评分有显著差别（P＞0.05）。结论：采用无内固定装置双束ACL 重建方法能够较好的平衡患者前内侧束和后外侧束张力，并有利于保留ACL 韧带残余结构、节约经费，具有令人满意的临床效果。

英文摘要:

Objective: To evaluate the treating effects of an internal fixation-free technique for the reconstruction of anterior cruciate ligament (ACL). Method: From January 2005 to January 2008, we treated 33 ACL injury patients by an internal fixation-free technique. They were 31 male and 2 female. After surgical contraindications were excluded, all the patients were treated with a novel fixation method. The anteromedial bundle of ACL was reconstructed with semitendinosius and the posterolateral bundle was reconstructed with gracilis. Both the two tendons were fixed by an internal fixation-free technique. The rehabilitation practiced during 1 to 3 weeks after operation under the protection of brace. Results: The results of short term follow-up showed that all the cuts were A healing and all the fixation were stable. The function of the knee joint was measured by Lysholm and IKDC scores. Pre-operation the average Lysholm score of the patients was 52.2±2.5, and 12 months post-operation the score was raised to 96.4±7.2. And the pre-operation the average IKDC scores of the patients were 55.3±3.7, and 12 months post-operation the score was raised to 94.1±5.3. There were significant differences between the scores of pre-operation and post-operation. Conclusions: The internal fixation-free technique can balance the tension between the anteromedial bundle and posterolateral bundle of ACL without damaging its stump.

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