中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2014年
3期
217-221
,共5页
丁杰%戴文敏%李晨曦%贺忱%周敬滨%李方祥
丁傑%戴文敏%李晨晞%賀忱%週敬濱%李方祥
정걸%대문민%리신희%하침%주경빈%리방상
前交叉韧带%前内束%后外束%定位%软组织标记%胫骨止点
前交扠韌帶%前內束%後外束%定位%軟組織標記%脛骨止點
전교차인대%전내속%후외속%정위%연조직표기%경골지점
anterior cruciate ligament%anteromedial bundle%posterolateral bundle%position%soft tissue landmarks%tibial at-tachment
背景：膝关节前交叉韧带（ACL）重建时，胫骨骨道定位不准会产生重建韧带与髁间窝的撞击或起不到维持膝关节稳定性的作用。因此，确定ACL胫骨止点的位置非常重要。目的：研究膝关节ACL胫骨止点前内束（AMB）和后外束（PLB）与软组织标记后交叉韧带（PCL）和外侧半月板前角的距离，从而明确ACL胫骨止点在胫骨平台的位置，为ACL损伤双束重建提供理论支持。方法：解剖18个膝关节尸体标本（左膝10个，右膝8个），测量ACL中点、AMB中点、PLB中点与PCL和外侧半月板前角的距离，并分析左、右膝关节是否存在差异。结果：AMB中点与PCL和外侧半月板前角的距离分别为（15.00±3.97）mm和（19.78±4.10）mm；PLB中点与两者的距离分别为（10.17±5.56）mm和（19.50±4.40）mm；ACL中点与两者的距离分别为（12.67±4.52）mm和（19.61±3.87）mm。左右膝关节ACL中点、AMB中点、PLB中点与软组织解剖标记的距离无明显统计学差异。结论：膝关节ACL损伤行手术重建时，可采用PCL和外侧半月板前角作为定位标记。
揹景：膝關節前交扠韌帶（ACL）重建時，脛骨骨道定位不準會產生重建韌帶與髁間窩的撞擊或起不到維持膝關節穩定性的作用。因此，確定ACL脛骨止點的位置非常重要。目的：研究膝關節ACL脛骨止點前內束（AMB）和後外束（PLB）與軟組織標記後交扠韌帶（PCL）和外側半月闆前角的距離，從而明確ACL脛骨止點在脛骨平檯的位置，為ACL損傷雙束重建提供理論支持。方法：解剖18箇膝關節尸體標本（左膝10箇，右膝8箇），測量ACL中點、AMB中點、PLB中點與PCL和外側半月闆前角的距離，併分析左、右膝關節是否存在差異。結果：AMB中點與PCL和外側半月闆前角的距離分彆為（15.00±3.97）mm和（19.78±4.10）mm；PLB中點與兩者的距離分彆為（10.17±5.56）mm和（19.50±4.40）mm；ACL中點與兩者的距離分彆為（12.67±4.52）mm和（19.61±3.87）mm。左右膝關節ACL中點、AMB中點、PLB中點與軟組織解剖標記的距離無明顯統計學差異。結論：膝關節ACL損傷行手術重建時，可採用PCL和外側半月闆前角作為定位標記。
배경：슬관절전교차인대（ACL）중건시，경골골도정위불준회산생중건인대여과간와적당격혹기불도유지슬관절은정성적작용。인차，학정ACL경골지점적위치비상중요。목적：연구슬관절ACL경골지점전내속（AMB）화후외속（PLB）여연조직표기후교차인대（PCL）화외측반월판전각적거리，종이명학ACL경골지점재경골평태적위치，위ACL손상쌍속중건제공이론지지。방법：해부18개슬관절시체표본（좌슬10개，우슬8개），측량ACL중점、AMB중점、PLB중점여PCL화외측반월판전각적거리，병분석좌、우슬관절시부존재차이。결과：AMB중점여PCL화외측반월판전각적거리분별위（15.00±3.97）mm화（19.78±4.10）mm；PLB중점여량자적거리분별위（10.17±5.56）mm화（19.50±4.40）mm；ACL중점여량자적거리분별위（12.67±4.52）mm화（19.61±3.87）mm。좌우슬관절ACL중점、AMB중점、PLB중점여연조직해부표기적거리무명현통계학차이。결론：슬관절ACL손상행수술중건시，가채용PCL화외측반월판전각작위정위표기。
Background:The inaccuracy of tibial tunnel position in anterior cruciate ligament (ACL) reconstruction will cause impinge-ment between the graft and intercondylar notch and also lead to instability of the knee. Therefore, it is very important to choose a proper tibial insertion site. Objective:To investigate the tibial anatomy of the anteromedial and posterolateral bundles, and to provide a guideline dur-ing double-bundle ACL reconstruction. Methods:The position of tibial attachment of the centre of ACL, anteromedial and posterolateral bundles relative to soft tis-sue landmarks were measured in 18 cadaveric knees. The difference between left and right knees was compared. Results: The distance between the center of anteromedial bundle and PCL, and anterior root of the lateral meniscus was (15.00 ± 3.97) mm and (19.78 ± 4.10) mm. The distance between the center of posterolateral bundle and PCL, and anterior root of the lateral meniscus was (10.17±5.56) mm and (19.50±4.40) mm. The distance between the center of ACL and PCL, and anterior root of the lateral meniscus was (12.67 ± 4.52) mm and (19.61 ± 3.87) mm, respectively. There were no signifi-cant differences in the distance between the centers of ACL, anteromedial bundle, posterolateral bundle and soft tissue land-marks between knees. Conclusions:The anterior root of the lateral meniscus and PCL can provide easily identifiable accurate reference points dur-ing ACL reconstruction for knee injury.
