中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
2期
123-127
,共5页
铁楷%陈廖斌%王华%王欣
鐵楷%陳廖斌%王華%王訢
철해%진료빈%왕화%왕흔
骨密度%前交叉韧带%体层摄影术,X线计算机%光密度测定法,X线
骨密度%前交扠韌帶%體層攝影術,X線計算機%光密度測定法,X線
골밀도%전교차인대%체층섭영술,X선계산궤%광밀도측정법,X선
Bone density%Anterior cruciate ligament%Tomography,X-ray computed%Densitometry,X-ray
目的 比较前十字韧带(anterior cruciate ligament,ACL)重建术股骨侧与胫骨侧骨隧道区域的骨密度,为选择界面螺钉大小提供参考.方法 招募30名年龄18～35岁的健康志愿者,用双能X线吸收(Dual-energy X-ray absorptiometry,DEXA)骨密度仪进行右下肢股骨侧与胫骨侧骨隧道区域骨密度测量；以CT薄层扫描右侧膝关节,利用三维立体成像技术分别确定经过骨隧道中心轴的股骨与胫骨隧道截面并测量灰度值.2010年8至10月ACL撕裂确诊患者9例,在重建手术过程中完整取出股骨侧与胫骨侧骨隧道内松质骨柱,应用阿基米德原理测量体积骨密度.结果 DEXA测量股骨侧隧道区域骨密度为(1.162±0.034)g/cm2,胫骨侧为(0.814±0.038)g/cm2,两者差异有统计学意义(t=9.11,P=0.000)；骨隧道区域CT股骨侧灰度值为(211.7±11.5)Hu,胫骨侧为(104.9±7.4)Hu,两者差异有统计学意义(t=10.15,P=0.000)；股骨侧骨柱体积骨密度为(2.80±0.88)g/cm3,胫骨侧骨柱为(1.88±0.59)g/cm3,两者差异有统计学意义(t=4.32,P=0.002).结论 ACL重建术股骨侧隧道松质骨密度大于胫骨侧.
目的 比較前十字韌帶(anterior cruciate ligament,ACL)重建術股骨側與脛骨側骨隧道區域的骨密度,為選擇界麵螺釘大小提供參攷.方法 招募30名年齡18～35歲的健康誌願者,用雙能X線吸收(Dual-energy X-ray absorptiometry,DEXA)骨密度儀進行右下肢股骨側與脛骨側骨隧道區域骨密度測量；以CT薄層掃描右側膝關節,利用三維立體成像技術分彆確定經過骨隧道中心軸的股骨與脛骨隧道截麵併測量灰度值.2010年8至10月ACL撕裂確診患者9例,在重建手術過程中完整取齣股骨側與脛骨側骨隧道內鬆質骨柱,應用阿基米德原理測量體積骨密度.結果 DEXA測量股骨側隧道區域骨密度為(1.162±0.034)g/cm2,脛骨側為(0.814±0.038)g/cm2,兩者差異有統計學意義(t=9.11,P=0.000)；骨隧道區域CT股骨側灰度值為(211.7±11.5)Hu,脛骨側為(104.9±7.4)Hu,兩者差異有統計學意義(t=10.15,P=0.000)；股骨側骨柱體積骨密度為(2.80±0.88)g/cm3,脛骨側骨柱為(1.88±0.59)g/cm3,兩者差異有統計學意義(t=4.32,P=0.002).結論 ACL重建術股骨側隧道鬆質骨密度大于脛骨側.
목적 비교전십자인대(anterior cruciate ligament,ACL)중건술고골측여경골측골수도구역적골밀도,위선택계면라정대소제공삼고.방법 초모30명년령18～35세적건강지원자,용쌍능X선흡수(Dual-energy X-ray absorptiometry,DEXA)골밀도의진행우하지고골측여경골측골수도구역골밀도측량；이CT박층소묘우측슬관절,이용삼유입체성상기술분별학정경과골수도중심축적고골여경골수도절면병측량회도치.2010년8지10월ACL시렬학진환자9례,재중건수술과정중완정취출고골측여경골측골수도내송질골주,응용아기미덕원리측량체적골밀도.결과 DEXA측량고골측수도구역골밀도위(1.162±0.034)g/cm2,경골측위(0.814±0.038)g/cm2,량자차이유통계학의의(t=9.11,P=0.000)；골수도구역CT고골측회도치위(211.7±11.5)Hu,경골측위(104.9±7.4)Hu,량자차이유통계학의의(t=10.15,P=0.000)；고골측골주체적골밀도위(2.80±0.88)g/cm3,경골측골주위(1.88±0.59)g/cm3,량자차이유통계학의의(t=4.32,P=0.002).결론 ACL중건술고골측수도송질골밀도대우경골측.
Objective To compare the bone mineral density of the regions of femoral and tibial tunnels for anterior cruciate ligament(ACL)reconstruction in order to provide reference for the choice of optimal screw diameter for interference fixation.Methods Thirty healthy volunteers aged from 18 to 35 years were enrolled in our study,and the dual-energy X-ray absorptiometry(DEXA)was used to measure the bone mineral density of femoral and tibial tunnel regions of the right knee.All the right knees of the volunteers were also scanned by spiral CT and three-dimensional reconstruction technique was utilized to determine the circular sections that pass through the longitudinal axis of the femoral and tibial tunnels separately.The CT gray scale values of the Sections were measured.From August to October 2010,9 patients who had been diagnosed as ACL rupture underwent the operation of ACL reconstruction,and cylindrical cancellous bone peg was removed from the femoral and tibial tunnel respectively during the operation.Volumetric bone mineral density of the bone pegs were measured by using a standardized immersion technique according to Archimedes’ principle.Results Measured by DEXA,bone density of the femoral tunnel region arid tibial tunnel region were(1.162±0.034)g/cm2 and(0.814±0.038)g/cm2 respectively.The difference was significant between the femoral and tibial tunnel region(t=9.11,P=0.000).The CT gray scale value of the section for femoral tunnel region was(211.7±11.5)Hu,while that of the tibial tunnel region was(104.9±7.4)Hu.There was statistically significant difference between them(t=10.15,P=0.000).The volumetric bone mineral density of the bone peg from femoral tunnel and tibial tunnel were(2.80±0.88)g/cm3 and(1.88±0.59)g/cm3 respectively.The difference was statistically significant(t=4.32,P=0.002).Conclusion For ACL reconstruction,bone mineral density of femoral tunnel region is higher than that of the tibial tunnel.
