前交叉韧带重建术中等长点确定的临床研究  

Clinical Study of Isometric Point Searching in Reconstruction of Anterior Cruciate Ligament

作　　者：傅捷[1] 刘春生[1] 张巍[1] 郝岩[1] 张树明[1] 

机构地区：[1]解放军第二炮兵总医院骨科,北京市100088

出　　处：《中国骨与关节损伤杂志》2009年第2期118-120,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的研究前交叉韧带单束重建中等长点位置寻找的方法及术后效果。方法选择25例单纯前交叉韧带断裂病例,使用四股的半腱肌和骨薄肌肌腱关节镜下重建前交叉韧带。术中综合应用解剖定位和透视定位方法初步确定等长点,检查等长效果(误差控制在2mm以内)。记录股骨隧道内口中央点选点次数及变点方向。术后1年随访,行Lysolm膝关节功能评分。结果17例选点1次。8例变更了股骨选点位置,5例上移,1例下移,2例后上移动,选点次数为1～4次,平均约1.36次。术后随访19例,Lysolm评分92～100分,平均97.5分。结论在股骨隧道内口初步选点后行等长效果检查,对保证手术质量有非常重要的意义。无论是解剖定位法还是透视定位法,都不能保证在所有病例中的等长效果。Objective To study the isometric point searching methods and the clinical result after reconstruction of anterior cruciate ligament （ACL）. Methods Twenty- five cases of simplex ACL rupture were selected, and ACL was reconstructed using quadrupled semi- tendinosus tendon and gracilis tendon under arthroscope. During surgery, the isometric points were searched by anatomical method and X- ray assistant method synthetically. The isometric result was tested. If the result fell short of the criterion （less than 2 mm）, the point for femoral tunnel had to be searched again. The times and the direction of the point changing were noted. Patients were followed up after 12 months averagely according to Lysholm knee scale score. Results In 17 cases, the isometric point was searched only once; and in the other 8 cases, the points were changed. The points were moved upward in 5 cases, downward in 1 case, upward and back- ward in 2 cases. The searching times for isometric point were from 1 to 4 times separately （average 1.36 times）. Nineteen cases were followed up. Lysholm knee scale score ranged from 92 to 100 （average 97.5）. Conclusion After the point for femoral tunnel is select- ed, the isometric result should be tested for the assurance of clinical result after surgery. Neither anatomical method nor X - ray assistant method can guarantee the isometric result in all cases.

关 键 词：前交叉韧带 重建 等长点 

分 类 号：R686.5[医药卫生—骨科学] R687.2[医药卫生—外科学]