中华关节外科杂志(电子版)
中華關節外科雜誌(電子版)
중화관절외과잡지(전자판)
CHINESE JOURNAL OF JOINT SURGERY(ELECTRONIC VERSION)
2015年
4期
505-510
,共6页
王辉%韩雪松%王金水%王万明
王輝%韓雪鬆%王金水%王萬明
왕휘%한설송%왕금수%왕만명
前交叉韧带%重建%股骨
前交扠韌帶%重建%股骨
전교차인대%중건%고골
Anterior cruciate ligament%Reconstruction%Femur
目的:研究由外向内法(OI)与经前内侧入路法(AM)重建前交叉韧带(ACL)股骨侧隧道相关参数及隧道长度与股骨髁部大小的关系,探寻二者区别。方法取15具新鲜解冻膝关节标本,测量股骨髁部左右径及股骨外侧髁前后径大小,采用自行改进的内钩槽游标卡尺,定位ACL股骨侧止点中心,分别模拟采用OI法与AM法定位股骨外侧壁隧道口点。测量隧道长度、隧道口点与股骨外上髁位置关系。正侧位X线位上股骨隧道与膝关节线、股骨纵轴夹角。结果 OI法股骨隧道长度为(36.9±2.5)mm,AM法为(35.0±2.1)mm,差异有统计学意义(P<0.05);OI法与AM法股骨外侧壁隧道口点均位于股骨外上髁近前侧。 OI法较AM法偏近心端分布,但AM法更为集中;股骨髁部越大,隧道长度越长。 OI法较AM法隧道更为垂直。结论采用OI法与AM法均可满足ACL重建术对股骨隧道长度及位置的要求。 OI法相比下更随意,不受屈膝角度的影响。
目的:研究由外嚮內法(OI)與經前內側入路法(AM)重建前交扠韌帶(ACL)股骨側隧道相關參數及隧道長度與股骨髁部大小的關繫,探尋二者區彆。方法取15具新鮮解凍膝關節標本,測量股骨髁部左右徑及股骨外側髁前後徑大小,採用自行改進的內鉤槽遊標卡呎,定位ACL股骨側止點中心,分彆模擬採用OI法與AM法定位股骨外側壁隧道口點。測量隧道長度、隧道口點與股骨外上髁位置關繫。正側位X線位上股骨隧道與膝關節線、股骨縱軸夾角。結果 OI法股骨隧道長度為(36.9±2.5)mm,AM法為(35.0±2.1)mm,差異有統計學意義(P<0.05);OI法與AM法股骨外側壁隧道口點均位于股骨外上髁近前側。 OI法較AM法偏近心耑分佈,但AM法更為集中;股骨髁部越大,隧道長度越長。 OI法較AM法隧道更為垂直。結論採用OI法與AM法均可滿足ACL重建術對股骨隧道長度及位置的要求。 OI法相比下更隨意,不受屈膝角度的影響。
목적:연구유외향내법(OI)여경전내측입로법(AM)중건전교차인대(ACL)고골측수도상관삼수급수도장도여고골과부대소적관계,탐심이자구별。방법취15구신선해동슬관절표본,측량고골과부좌우경급고골외측과전후경대소,채용자행개진적내구조유표잡척,정위ACL고골측지점중심,분별모의채용OI법여AM법정위고골외측벽수도구점。측량수도장도、수도구점여고골외상과위치관계。정측위X선위상고골수도여슬관절선、고골종축협각。결과 OI법고골수도장도위(36.9±2.5)mm,AM법위(35.0±2.1)mm,차이유통계학의의(P<0.05);OI법여AM법고골외측벽수도구점균위우고골외상과근전측。 OI법교AM법편근심단분포,단AM법경위집중;고골과부월대,수도장도월장。 OI법교AM법수도경위수직。결론채용OI법여AM법균가만족ACL중건술대고골수도장도급위치적요구。 OI법상비하경수의,불수굴슬각도적영향。
Objective To investigate the difference between the outside-in ( OI ) method and anteromedial ( AM) portal by analyzing the parameters of femoral tunnel and the relationship between the length of the femoral tunnel and the size of femoral condyle during anterior cruciate ligament ( ACL ) reconstruction.Methods Fifteen fresh cadaveric knees were selected to locate the center of ACL femoral footprint using the modified hook-slot vernier caliper and the tunnel entrance on the lateral side of femur using OI method and AM portal respectively .The femoral tunnel length , the relationship of the tunnel entrance and the lateral epicondyle , the angles formed by the tunnel , knee joint line and longitudinal femoral axis in the anteroposterior and lateral radiographs , and the size of femoral condyle were measured . Results The length of femoral tunnel according to OI method was significantly longer than AM portal ( P<0.05 ) .The entrances of the femoral tunnel both located at the lateral epicondyle of the femur proximal to the anterior region in OI and AM methods .The tunnel entrances of OI method located more proximally than those of AM portal , but they were more concentrated in AM portal .OI method showed a more vertical tunnel than AM portal .The bigger femoral condyles showed the longer femoral tunnel . Conclusion Both of OI method and AM portal can meet the requirements of femoral tunnel length and position in ACL reconstruction;OI method is more casual which is not influenced by the flexion angle of the knee.