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前交叉韧带重建术股骨侧定位点及移植物直径变化与膝关节旋转稳定性相关性研究

Correlation between fixation of femoral fixation and change of graft diameter and rotation stability of knee joint in reconstruction of anterior cruciate ligament

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【作者】 王震宇李亦丞孙学斌刘阳李纲尼加提·阿不力米提张克远

【Author】 WANG Zhen-yu;LI Yi-cheng;SUN Xue-bin;LIU Yang;LI Gang;NIJIATI Abulimiti;ZHANG Ke-yuan;Osteoplastic Surgery,the First Affiliated Hospital,Xinjiang Medical University;

【机构】 新疆医科大学第一附属医院骨肿瘤外科

【摘要】 目的根据前交叉韧带重建术后胫骨结节与股骨滑车沟的距离(TT-TG值)的变化,探讨股骨侧隧道定位点和移植物直径对膝关节旋转稳定性的影响。方法回顾性分析自2016-03—2016-10诊治42例前交叉韧带损伤,均行韧带重建术,根据术后CT三维重建结果,行2种试验,A试验:股骨侧隧道(移植物)直径一致,比较不同隧道定位点与膝关节TT-TG值的相关性。B试验:股骨侧定位点一致,比较不同的隧道直径与膝关节TT-TG值的相关性。结果 A试验中,移植物直径恒定,随着定位点越接近后外侧束,TT-TG值越大。B试验中,定位点保持一致,隧道直径越不同,TT-TG值差异无统计学意义。结论前交叉韧带重建后,股骨侧定位点越靠近后外侧束附丽区,矫正因前交叉韧带损伤导致的膝关节内旋畸形的能力越强即TT-TG值越大,因此后外侧束对维持膝关节旋转稳定性十分重要。移植物直径对膝关节旋转稳定性影响不显著。

【Abstract】 Objective To investigate the effects of femoral tunnel positioning and graft diameter on knee rotation stability,based on the changes of TT-TG after reconstruction of anterior cruciate ligament.Methods Retrospective analysis of diagnosis and treatment of 42 cases of anterior cruciate ligament injury from March 2016 to October 2016 was conducted.All patients received ligament reconstruction,according to postoperative CT three-dimensional reconstruction results,2 experiments were performed.A experiment:femoral tunnel(graft) diameter consistent to compare the correlation between TTTG values of different tunnel loci and knee.B experiment:the same location of the femoral fixation,compared with different tunnel diameter and knee TT-TG value of the correlation.Results In experiment A,the diameter of the graft was constant,as the fixation point approached the posterior lateral bundle,the TT-TG value became larger.In experiment B,the fixation points were consistent,the diameter of the tunnel was different,and the TT-TG was not statistically significant.Conclusion After the reconstruction of the anterior cruciate ligament,the lateral fixation of the femoral side is closer to the posterior lateral bundle attachment area,and the greater the ability of the knee to be pronounced due to the injury of the anterior cruciate ligament,the greater the TT-TG value.This shows that the posterior lateral bundle to maintain the rotation of the knee joint rotation can not be ignored.According to experiment 2,the results suggest that the graft diameter has no significant effect on the rotation stability of the knee joint.

【基金】 新疆维吾尔自治区自然科学基金联合基金(2016D01C286)
  • 【文献出处】 中国骨与关节损伤杂志 ,Chinese Journal of Bone and Joint Injury , 编辑部邮箱 ,2017年12期
  • 【分类号】R687.4
  • 【被引频次】9
  • 【下载频次】150
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