【摘要】 目的：關節(jié)鏡下經(jīng)后內側后外側和后縱隔入路保留板股韌帶和殘留的后交叉韌帶（PCL）纖維重建PCL，探討此技術的臨床應用效果。方法：對9例PCL損傷患者在關節(jié)鏡下結合常規(guī)關節(jié)鏡入路和后內側后外側入路及后縱隔入路保留板股韌帶和殘留的PCL纖維應用自體腘繩肌腱重建PCL。在后外側入路的關節(jié)鏡監(jiān)視下，脛骨隧道定位在PCL脛骨止點外側關節(jié)面下方1～1.5cm。股骨隧道經(jīng)前外側入路定位于股骨內側髁關節(jié)軟骨后方1cm。自體肌腱移植物利用鋼絲引導通過骨隧道，移植物兩端用可吸收界面螺釘固定。術后6個月了解膝關節(jié)功能恢復情況。結果：9例患者均獲隨訪，時間7～14個月，平均8.6個月。術后6個月，患者均無伸膝受限；2例有10°～15°屈膝受限；1例有Ⅰ度后抽屜試驗陽性。Lysholm膝關節(jié)功能評分術前（47.6±14.9），術后6個月（92.9±4.6）（P＜0.01）。結論：膝關節(jié)后內外側入路和后縱隔入路重建PCL的方法，鏡下視野清楚、無盲區(qū)，操作安全，韌帶的脛骨止點定位準確，短期療效肯定?！娟P鍵詞】 膝關節(jié)；關節(jié)鏡檢查；后交叉韌帶；重建手術方式Arthroscopic posterior cruciate ligament reconstruction using the posterior portalZHAO Jia-yi, ZHENG Jie, Li Xie-hai, He Shi-hui, HE Yu-qingDepartment of Orthopedic Surgery, ZhoushanHospital, Zhoushan 316000,China【Abstract】 Objective To introduce the arthroscopic posterior cruciate ligament (PCL) reconstruction using the posteromedial portal, the posterolateral portal and the posterior trans-septal portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments,and to evaluate the clinical results. Methods 9 cases of PCL injury were treated with the autogenous hamstring tendon arthroscopically through the routine portal, the posteromedial portal, the posterolateral portal and the posterior trans-septal portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments.The tibial drill guide was introduced through the anteromedial portal and positioned on the fossa for the PCL on the tibial, 1 to 1.5cm below the articular surface and just lateral to the midline, under arthroscopic guidance from the posterolateral portal. The femoral tunnel was made 1 cm posterior to the articular cartilage of the medial femoral condyle by use the guide pin introduced through the anterolateral portal. The tendon graft was positioned in the knee joint by use of the tibial and femoral double-folded silk loops that traversed the bony tunnels. The graft was fixed by use of bioabsorbable Intrafix screw systems at both the ends. The total knee function was evaluated with Lysholm scale after six months postoperatively. Results All case were followed up for an average 8.6 months (range,7 to 14 months), Six months postoperatively knee extension restored to normal in all cases;10°to 15°flexion limitation was found in 2 cases; one case with Ⅰdegree of positive posterior drawer test was found. The Lysholm knee score were 47.6±14.9 before operation and 92.9±4.6 after 6 months postoperatively. There was significant difference between preoperation and postoperatively (P＜0.01). Conclusions The method of arthroscopic PCL reconstruction using the posteromedial portal, the posterolateral portal and the posterior trans-septal portal with preservation of the remnant PCL fibers and intact meniscofemoral ligaments provides adequate exposure of the posterior knee compartment ,safe and accurate placement of the tbial tunnel; The short-term results of the technique are encouraging.