前交叉韧带重建术中经胫骨的股骨隧道足迹定位方法改进及术后骨道评估

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武警医学 ›› 2012, Vol. 23 ›› Issue (5) : 395-399.

论著

张鹏礼^1，2，王耀霆¹，贾一明³，刘水涛⁴，金海超¹，邢更彦^1,2

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Improved footprint location of the femoral tunnel via the tibia and post-operative assessment of the bone tunnel in anterior cruciate ligament reconstruction

ZHANG Pengli^1，2，WANG Yaoting¹，JIA Yiming³，LIU Shuitao⁴, and XING Gengyan^1，2.

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摘要

目的探讨前交叉韧带重建术中经胫骨的股骨隧道足迹定位方法的改进及术后骨道位置评估。方法分析2007 -06至2010-01于武警总医院行自体半腱肌腱和股薄肌腱单束重建前交叉韧带手术患者196例，应用改进的方法进行关节镜下经胫骨的股骨隧道足迹定位，并应用国际膝关节文献委员会（international knee documentation commitee, IKDC）评分及术后MRI行骨道位置评估的资料。结果经随访10～36个月，患者的前抽屉试验及Lachman试验均为阴性，IKDC评分情况均较术前差异有统计学意义( P <0.05) ，采用矢状位上关节线与移植肌腱的夹角(the angle between the joint line and the graft on the sagittal view，JGS)和冠状位上关节线与移植肌腱的夹角(the angle between the joint line and the graft on the coronal image，JGC) ，对术后6个月及正常侧膝关节MRI行骨道位置评估，重建的前交叉韧带的位置与正常对照组的位置差异无统计学意义（ P >0.05）。结论单束重建前交叉韧带时，改进的经胫骨的股骨隧道的足迹定位方法是理想的股骨隧道定位方法，患者关节稳定性与功能均得到显著改善；采用JGS和JGC对骨道位置进行评估可较客观、准确地反映股骨隧道定位情况，骨隧道位置与临床效果相关。

Abstract

Objective To establish an improved method of footprint location of the femoral tunnel via the tibia and post-operative assessment of the bone tunnel in anterior cruciate ligament (ACL) reconstruction. Methods 196 patients were investigated who underwent the single-bundle ACL reconstruction with autogenous semitendinosus tendon and gracilis tendon using the improved method of footprint location of the femoral tunnel via the tibia under arthroscopy from June 2007 to January 2010. The position of the femoral tunnel was measured by MRI and the knee function was assessed by IKDC scores. Results After a follow-up of 10-36 months, anterior drawer tests and Lachman tests in the patients were all negative. The IKDC scores increased significantly( P <0.05). The location of the bone tunnel was evaluated by the angle between the joint line and the graft on the sagittal view(JGS) and the angle between the joint line and the graft on the coronal image(JGC )on MRI after 6 months and there was no difference in the position of the anterior cruciate ligament between the reconstruction group and control group( P >0.05) . Conclusions The improved method of footprint location of the femoral tunnel via the tibia in single-bundle ACL reconstruction is an ideal method . The stability and functions of knees of the patients can improved significantly. The measurement of knees using JGS and JGC can reflect the tunnel positions objectively and accurately,which are related to the clinical effect.

导出引用

张鹏礼，王耀霆，贾一明，刘水涛，金海超，邢更彦. 前交叉韧带重建术中经胫骨的股骨隧道足迹定位方法改进及术后骨道评估[J]. 武警医学. 2012, 23(5): 395-399

Improved footprint location of the femoral tunnel via the tibia and post-operative assessment of the bone tunnel in anterior cruciate ligament reconstruction[J]. Medical Journal of the Chinese People Armed Police Forces. 2012, 23(5): 395-399

中图分类号： R684.7

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