探讨关节外肌腱固定术对前交叉韧带（ACL）损伤合并重度轴移现象患者术后关节功能及稳定性的临床效果。

回顾性选取2020年1月至2023年6月唐山市第二医院关节一科收治的164例ACL损伤合并重度轴移现象（轴移试验Ⅲ级）患者，其中男104例、女60例，年龄20~45岁，平均（28.8±5.1）岁，病程1~8周，平均（4.0±1.4）周，损伤左侧86例、右侧78例，合并半月板损伤67例。根据手术方式分为联合组（82例，行关节外肌腱固定术联合ACL重建术）和单纯组（82例，行单纯ACL重建术）。

最终162例患者获得满意随访，随访率98.78%，随访时间22.5~25.5个月，平均（24.0±1.5）个月；其中联合组实际随访81例，随访时间22.5~25.3个月，平均（23.9±1.6）个月，单纯组实际随访81例，随访时间22.6~25.5个月，平均（24.1±1.4）个月。术后6个月、1年，联合组轴移试验及Lachman试验阴性率、Lysholm评分、IKDC评分均显著高于单纯组，术后2年联合组移植物优良率显著高于单纯组（P<0.05），具体数值为：术后6个月联合组轴移试验阴性率93.8%（76/81）、Lachman试验阴性率96.3%（78/81），Lysholm评分（78.5±6.3）分、IKDC评分（76.8±5.7）分，单纯组则分别为72.8%（59/81）、76.5%（62/81），（70.2±5.9）分、（68.3±6.2）分；术后1年联合组轴移试验阴性率98.8%（80/81）、Lachman试验阴性率100.0%（81/81），Lysholm评分（85.7±4.8）分、IKDC评分（84.2±4.5）分，单纯组则分别为80.2%（65/81）、83.9%（68/81），（76.3±5.5）分、（73.5±5.9）分；术后2年联合组移植物优良率（0~Ⅰ级）97.5%（79/81），显著高于单纯组的81.5%（66/81）（P<0.05）。

关节外肌腱固定术对ACL重建术可有效提升ACL损伤合并重度轴移现象患者的术后关节稳定性与功能，保护移植物，且安全性良好。

To evaluate the clinical efficacy of extra-articular tendon fixation in patients with anterior cruciate ligament (ACL) injury combined with severe axial shift on postoperative joint function and stability.

Retrospectively, 164 patients with anterior cruciate ligament (ACL) injury complicated with severe pivot shift phenomenon (Grade Ⅲ pivot shift test) admitted to the First Department of Joint Surgery, Tangshan Second Hospital from January 2020 to June 2023 were enrolled in the study, including 104 males and 60 females, aged 20 to 45 years with a mean age of (28.8±5.1) years, having a disease course of 1 to 8 weeks with an average of (4.0±1.4) weeks. Among them, 86 cases suffered from left knee injury and 78 cases from right knee injury, with 67 cases complicated with meniscus injury. The patients were divided into two groups according to the surgical method adopted: the combined group (82 cases) treated with extra-articular tendon fixation combined with ACL reconstruction, and the control group (82 cases) treated with ACL reconstruction alone.

A total of 162 patients were successfully followed up at last, with a follow-up rate of 98.78%. The follow-up period ranged from 22.5 to 25.5 months, with a mean of (24.0±1.5) months. Specifically, 81 patients in the combined group were actually followed up, with a follow-up period of 22.5 to 25.3 months and a mean of (23.9±1.6) months; 81 patients in the simple group were actually followed up, with a follow-up period of 22.6 to 25.5 months and a mean of (24.1±1.4) months. At 6 months and 1 year postoperatively, the negative rates of pivot shift test and Lachman test, Lysholm scores and IKDC scores in the combined group were significantly higher than those in the simple group; at 2 years postoperatively, the excellent and good rate of grafts in the combined group was significantly higher than that in the simple group (P<0.05). The specific values were as follows: at 6 months postoperatively, the negative rate of pivot shift test and Lachman test in the combined group was 93.8% (76/81) and 96.3% (78/81) respectively, with the Lysholm score of (78.5±6.3) points and IKDC score of (76.8±5.7) points; while the corresponding indicators in the simple group were 72.8% (59/81), 76.5% (62/81), (70.2±5.9) points and (68.3±6.2) points respectively. At 1 year postoperatively, the negative rate of pivot shift test and Lachman test in the combined group was 98.8% (80/81) and 100.0% (81/81) respectively, with the Lysholm score of (85.7±4.8) points and IKDC score of (84.2±4.5) points; the corresponding indicators in the simple group were 80.2% (65/81), 83.9% (68/81), (76.3±5.5) points and (73.5±5.9) points respectively. At 2 years postoperatively, the excellent and good rate of grafts (Grade 0-Ⅰ) in the combined group was 97.5% (79/81), which was significantly higher than 81.5% (66/81) in the simple group (P<0.05).

Extra-articular tendon fixation combined with ACL reconstruction can effectively improve postoperative joint stability and function in patients with ACL injury and severe axial displacement, protect the graft, and demonstrate good safety.