網狀縫合聯合骨水泥包裹修復人工全膝關節置換術中醫源性內側副韌帶股骨止點撕脫三例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

劉宇博 ^1,2,3 , 孫輝 ^1,2,3 ^{共同第一作者} , 王博 ^1,2,3 , 謝聰欽 ^2,3,4 ,  余方圓 ^2,3,4 , 柴偉 ^2,3

1. ;
2. ;
3. ;
4. ;

Corresponding?author：

余方圓, Email: yufy-1@163.com

Keywords：

人工全膝關節置換術; 內側副韌帶; 股骨止點撕脫; 網狀縫合; 骨水泥; 韌帶修復

DOI：

10.7507/1002-1892.202603017

Video：

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目的總結網狀縫合聯合骨水泥包裹修復3例人工全膝關節置換術（total knee arthroplasty，TKA）中醫源性內側副韌帶（medial collateral ligament，MCL）股骨止點撕脫臨床經驗及早期療效。方法 2023年6月—2025年3月，3例膝骨關節炎患者初次TKA術中發生MCL股骨止點撕脫，均一期采用網狀縫合聯合骨水泥包裹技術修復，并同期完成假體植入。患者年齡65、75、77歲。術前膝關節屈曲活動度50°～70°，膝關節學會評分系統（KSS）臨床評分30～47分、功能評分15～33分。西安大略和麥克馬斯特大學骨關節炎指數（WOMAC）評分55～75分。均經雙能X線吸收法檢查診斷為骨質疏松。結果術后患者分別獲隨訪6、10、12個月。隨訪期間X線片復查示，股骨及脛骨假體位置均良好，骨水泥包裹區域形態穩定，未見修復結構移位、假體松動或周圍骨質異常改變。所有患者膝關節內側穩定性良好，疼痛、活動受限及日常生活能力均明顯改善。末次隨訪時，膝關節屈曲活動度達100°～120°，KSS臨床評分80～98分、功能評分70～85分，WOMAC評分下降至14～27分。結論對于TKA術中醫源性MCL股骨止點撕脫，網狀縫合聯合骨水泥包裹可提供較可靠的早期固定效果，尤其適用于骨質條件較差、傳統固定方法困難患者。

Citation： 劉宇博, 孫輝, 王博, 謝聰欽, 余方圓, 柴偉. 網狀縫合聯合骨水泥包裹修復人工全膝關節置換術中醫源性內側副韌帶股骨止點撕脫三例. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(8): 1320-1322. doi: 10.7507/1002-1892.202603017 Copy

1.	Amiri S, Mirahmadi A, Parvandi A, et al. Management of iatrogenic medial collateral ligament injury in primary total knee arthroplasty: a systematic review[J]. Arch Bone Jt Surg, 2024, 12(3): 159-166.
2.	Lu W, Deng Z, Essien AE, et al. Clinical research progress of internal brace ligament augmentation technique in knee ligament injury repair and reconstruction: a narrative review[J/OL]. J Clin Med, 2023, 12(5): 1999. doi: 10.3390/jcm12051999.
3.	AlThani S, Meshram P. Cement augmentation of suture anchor during arthroscopic rotator cuff repair in case of proximal humeral bone deficiency due to osteoporosis[J]. Arthrosc Tech, 2023, 12(6): e897-e902.
4.	Dayal D, Zalikha L, El-Othmani MM. Evaluating the optimal management strategy for intraoperative iatrogenic injury to the medial collateral ligament during primary total knee arthroplasty: A systematic review[J]. Knee, 2024, 48: 138-149.
5.	Frisch NB, Keller RA, Mueller JKP, et al. Treatment of medial collateral ligament injury during total knee arthroplasty with internal suture brace augmentation: a cadaveric and biomechanical study[J]. Orthopedics, 2022, 45(5): e269-e275.
6.	Guarin Perez SF, Alarcon Perico D, Mallet KE, et al. Medial collateral ligament repair with internal suture brace augmentation in total knee arthroplasty[J]. Arthroplast Today, 2025, 36: 101836. doi: 10.1016/j.artd.2025.101836.
7.	Blackwood NO, Blitz JA, Vopat B, et al. Medial collateral ligament reconstruction with autograft versus allograft: a systematic review[J]. Am J Sports Med, 2024, 52(13): 3419-3426.
8.	deMeireles AJ, El-Othmani MM, Gardner TR, et al. The effect of implant constraint and ligament repair on compartment balancing after medial collateral ligament injury in TKA[J]. J Bone Joint Surg (Am), 2025, 107(13): 1500-1505.

1. Amiri S, Mirahmadi A, Parvandi A, et al. Management of iatrogenic medial collateral ligament injury in primary total knee arthroplasty: a systematic review[J]. Arch Bone Jt Surg, 2024, 12(3): 159-166.
2. Lu W, Deng Z, Essien AE, et al. Clinical research progress of internal brace ligament augmentation technique in knee ligament injury repair and reconstruction: a narrative review[J/OL]. J Clin Med, 2023, 12(5): 1999. doi: 10.3390/jcm12051999.
3. AlThani S, Meshram P. Cement augmentation of suture anchor during arthroscopic rotator cuff repair in case of proximal humeral bone deficiency due to osteoporosis[J]. Arthrosc Tech, 2023, 12(6): e897-e902.
4. Dayal D, Zalikha L, El-Othmani MM. Evaluating the optimal management strategy for intraoperative iatrogenic injury to the medial collateral ligament during primary total knee arthroplasty: A systematic review[J]. Knee, 2024, 48: 138-149.
5. Frisch NB, Keller RA, Mueller JKP, et al. Treatment of medial collateral ligament injury during total knee arthroplasty with internal suture brace augmentation: a cadaveric and biomechanical study[J]. Orthopedics, 2022, 45(5): e269-e275.
6. Guarin Perez SF, Alarcon Perico D, Mallet KE, et al. Medial collateral ligament repair with internal suture brace augmentation in total knee arthroplasty[J]. Arthroplast Today, 2025, 36: 101836. doi: 10.1016/j.artd.2025.101836.
7. Blackwood NO, Blitz JA, Vopat B, et al. Medial collateral ligament reconstruction with autograft versus allograft: a systematic review[J]. Am J Sports Med, 2024, 52(13): 3419-3426.
8. deMeireles AJ, El-Othmani MM, Gardner TR, et al. The effect of implant constraint and ligament repair on compartment balancing after medial collateral ligament injury in TKA[J]. J Bone Joint Surg (Am), 2025, 107(13): 1500-1505.

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Chinese Journal of Reparative and Reconstructive Surgery

網狀縫合聯合骨水泥包裹修復人工全膝關節置換術中醫源性內側副韌帶股骨止點撕脫三例

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