中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
40期
6397-6401
,共5页
组织工程%组织构建实验模型%三维重建%关节镜%前交叉韧带%重建%骨道%自体肌腱%异体肌腱%移植物
組織工程%組織構建實驗模型%三維重建%關節鏡%前交扠韌帶%重建%骨道%自體肌腱%異體肌腱%移植物
조직공정%조직구건실험모형%삼유중건%관절경%전교차인대%중건%골도%자체기건%이체기건%이식물
背景：有研究表明影响前交叉韧带重建手术效果的因素主要取决于骨道的位置，而目前对骨道位置的研究仍存在一定争议。目的：探讨3D-CT对关节镜辅助下前交叉韧带重建后骨道评估的临床价值。方法：对2014年1月至8月收治的58例前交叉韧带损伤患者行关节镜下前交叉韧带重建。股骨端采用Endobutton固定，胫骨端使用可吸收界面钉固定。分别对58个膝关节进行双源CT扫描，使用CT图像后处理工作站重建膝关节三维模型，再现股骨外髁内侧壁及重建后单束骨道，胫骨平台及骨道。根据Lysholm评分分级办法，将随访时Lysholm评分≥80分病例作为优良组，80分以下为不良组，标记、测量股骨及胫骨骨道中心点的相对位置，比较两者的位置关系。结果与结论：3D-CT 三维重建法清晰地反映了膝关节前交叉韧带重建后的骨道及其出入口的位置、固定物及移植物等情况。膝关节功能优良组与不良组患者的术侧膝关节的股骨骨道中心位置之间差异有显著性意义(P <0.05)，胫骨骨道中心位置之间差异无显著性意义(P >0.05)。结果证实，3D-CT能够清晰重建骨隧道及前交叉韧带移植物的图像，临床上可用于评估骨隧道定位与移植物走形的关系。
揹景：有研究錶明影響前交扠韌帶重建手術效果的因素主要取決于骨道的位置，而目前對骨道位置的研究仍存在一定爭議。目的：探討3D-CT對關節鏡輔助下前交扠韌帶重建後骨道評估的臨床價值。方法：對2014年1月至8月收治的58例前交扠韌帶損傷患者行關節鏡下前交扠韌帶重建。股骨耑採用Endobutton固定，脛骨耑使用可吸收界麵釘固定。分彆對58箇膝關節進行雙源CT掃描，使用CT圖像後處理工作站重建膝關節三維模型，再現股骨外髁內側壁及重建後單束骨道，脛骨平檯及骨道。根據Lysholm評分分級辦法，將隨訪時Lysholm評分≥80分病例作為優良組，80分以下為不良組，標記、測量股骨及脛骨骨道中心點的相對位置，比較兩者的位置關繫。結果與結論：3D-CT 三維重建法清晰地反映瞭膝關節前交扠韌帶重建後的骨道及其齣入口的位置、固定物及移植物等情況。膝關節功能優良組與不良組患者的術側膝關節的股骨骨道中心位置之間差異有顯著性意義(P <0.05)，脛骨骨道中心位置之間差異無顯著性意義(P >0.05)。結果證實，3D-CT能夠清晰重建骨隧道及前交扠韌帶移植物的圖像，臨床上可用于評估骨隧道定位與移植物走形的關繫。
배경：유연구표명영향전교차인대중건수술효과적인소주요취결우골도적위치，이목전대골도위치적연구잉존재일정쟁의。목적：탐토3D-CT대관절경보조하전교차인대중건후골도평고적림상개치。방법：대2014년1월지8월수치적58례전교차인대손상환자행관절경하전교차인대중건。고골단채용Endobutton고정，경골단사용가흡수계면정고정。분별대58개슬관절진행쌍원CT소묘，사용CT도상후처리공작참중건슬관절삼유모형，재현고골외과내측벽급중건후단속골도，경골평태급골도。근거Lysholm평분분급판법，장수방시Lysholm평분≥80분병례작위우량조，80분이하위불량조，표기、측량고골급경골골도중심점적상대위치，비교량자적위치관계。결과여결론：3D-CT 삼유중건법청석지반영료슬관절전교차인대중건후적골도급기출입구적위치、고정물급이식물등정황。슬관절공능우량조여불량조환자적술측슬관절적고골골도중심위치지간차이유현저성의의(P <0.05)，경골골도중심위치지간차이무현저성의의(P >0.05)。결과증실，3D-CT능구청석중건골수도급전교차인대이식물적도상，림상상가용우평고골수도정위여이식물주형적관계。
BACKGROUND:Studies have shown that factors affecting the outcomes of anterior cruciate ligament reconstruction mainly depend on the position of bone tunnels. However, there stil exists certain controversy over the researches on the position of bone tunnels. OBJECTIVE:To investigate the clinical value of three-dimensional computed tomography on postoperative evaluation of bone tunnel after anterior cruciate ligament reconstruction under arthroscopic assistance. METHODS:Fifty-eight patients with anterior cruciate ligament injury who received the treatment from January 2014 to August 2014 underwent anterior cruciate ligament reconstruction under arthroscopic assistance. The femoral end was fixed using an Endobutton, and tibial end was fixed using absorbable interference screws. 58 knees from patients were scanned respectively by means of a dual-source CT scanner. A three-dimensional model of knee was rebuilt on a CT image post-processing workstation to reproduce the medial wal of the lateral femoral condyle and reconstruct single-bundle anterior cruciate ligament, tibial plateau and bone tunnel. The cases that had a Lysholm score≥ 80 points were included in the excelent and good group and those who had a Lysholm score < 80 points in the poor group. The relative position of the center point of the femoral and tibial bone tunnels were marked and measured and the position relation between the two center points was estimated. RESULTS AND CONCLUSION: Three-dimensional computed tomography reconstruction method clearly reflected the situation of bone tunnel and its entrance, fixtures and grafts after anterior cruciate ligament reconstruction. There was significant difference in the center point of femoral tunnel of the knee on the operated side between excelent and good group and poor group (P < 0.05). There was significant difference in the center point of the tibial tunnel between these two groups (P > 0.05). These results confirm that three-dimensional computed tomography can help to clearly reconstruct the images of bone tunnel and anterior cruciate ligament grafts after operation, which can be used clinicaly to assess the relationship between bone tunnel location and graft misshaping.
