CAJ | 학술논문

目的探讨关节镜下应用半腱肌、股薄肌肌腱重建膝前交叉韧带时股骨隧道定位及固定方法 .方法经临床及膝关节镜检查诊断的膝前交叉韧带损伤者86 例采取镜下修复,分别应用经由内向外及由外向内2种定位方法行股骨隧道定位;股骨隧道固定分别应用Endobutton、Rigidfix及可吸收挤压螺钉3种方法 .结果经随访10～26个月,Lachman征、前抽屉试验均为阴性,Lysholm评分从28分到70分,平均56.65分.结论股骨端隧道由内向外定位方法 (通过胫骨隧道)创伤略小,适用于Endobutton、Rigidfix等,但受胫骨隧道位置及角度影响,要使股骨端隧道定位点与前交叉韧带股骨外髁解剖止点完全吻合,必须建立精确位置及角度的胫骨隧道.而股骨端隧道由外向内定位方法创伤略大,适用于股骨端挤压螺钉固定,定位点不受胫骨隧道影响,与前交叉韧带股骨外髁解剖止点较易吻合;而各种股骨端固定方法各有利弊,选择最佳的股骨隧道及固定方法将有助于减少术后并发症.
목적 탐토관절경하응용반건기、고박기기건중건슬전교차인대시고골수도정위급고정방법 .방법 경림상급슬관절경검사진단적슬전교차인대손상자86 례채취경하수복,분별응용경유내향외급유외향내2충정위방법 행고골수도정위;고골수도고정분별응용Endobutton、Rigidfix급가흡수제압라정3충방법 .결과 경수방10～26개월,Lachman정、전추체시험균위음성,Lysholm평분종28분도70분,평균56.65분.결론 고골단수도유내향외정위방법 (통과경골수도)창상략소,괄용우Endobutton、Rigidfix등,단수경골수도위치급각도영향,요사고골단수도정위점여전교차인대고골외과해부지점완전문합,필수건립정학위치급각도적경골수도.이고골단수도유외향내정위방법 창상략대,괄용우고골단제압라정고정,정위점불수경골수도영향,여전교차인대고골외과해부지점교역문합;이각충고골단고정방법 각유리폐,선택최가적고골수도급고정방법 장유조우감소술후병발증.
Objective To investigate the selection of isometric points and bone tunnel′s angel in anterior cruciate ligament(ACL)reconstruction using quadrupled semitendinosus tendon and gracilis tendon under arthroscope.Methods Eighty-six patients with rupture of ACL were diagnosed through clinical and arthroscopic examination.Two techniques of femoral tunnel location(transtibial tunnel and outside-in)and three types of fixation were applied.Results Patients were followed up averagely for 10 to 26 months.According to Lysholm knee scale scoring,the average knee scores were 28 and 56.65 respectively before and after operation(P＜0.05).Conclusion Various femoral tunnel location and fixation methods have their own strengths and weaknesses.Selecting the best femoral tunnel location and fixed method will help reduce post-operative complications.