Intrafix与界面螺钉在前交叉韧带重建中的生物力学研究  

Biomechanical evaluation of tendon graft fixation at the tibial site in anterior cruciate ligament reconstruction with Intrafix and bioabsorbable interference screw

作　　者：王俊良[1] 刘玉杰[1] 王爱媛[1] 杨玉明[1] 李海峰[1] 李众利[1] 王志刚[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《中华医学杂志》2009年第13期886-889,共4页National Medical Journal of China

基　　金：国家科技支撑计划（2007BA104B09）

摘　　要：目的探讨胭绳肌腱移植重建前交叉韧带（ACL）胫骨端界面螺钉与Intrafix固定的生物力学。方法新鲜冰冻尸体膝关节标本14具，采用四股胭绳肌腱移植重建ACL，胫骨端分别采用可吸收界面螺钉（n=7）和Intrafix（n=7）固定，测试最大载荷、100kg·m·s^-2和400kg·m·s^-2位移、抗拉刚度、失败模式等数据并进行统计学分析。结果Intrafix固定组的最大载荷大于可吸收界面螺钉组，两组间差异有统计学意义（t=0．003，P〈0．05）；100kg·m·s^-2位移和400kg·m·s^-2位移两组间差异无统计学意义（t=0．2173、0．0944，P〉0．05），抗拉刚度两组间差异无统计学意义（t=0．0967，P〉0．05）。结论四股胭绳肌腱移植重建ACL，胫骨端采用可吸收界面螺钉和Intrafix固定均可满足ACL初期固定强度的需求；Intrafix固定强度大于可吸收界面螺钉。Objective The fixation strength of the hamstring tendon graft on the tibial side is considered the weak point in anterior crueiate ligament （ACL） reconstruction. This work tested the hypotheses that some of these devices will resist graft slippage under loads better than others, and that some will have higher ultimate strength than others. Methods Fourteen fresh frozen human cadaver knees underwent fixation of the hamstring tendon harvested from the knee to be used as graft material to reconstruct the ACL and were divided into two equal groups based on the fixation methods： bioabsorbable interference screw group and Intrafix group. A MTS 858 MiniBionix Ⅱ testing machine was used to carry out tensile testing under an axial load parallel to the tibial tunnel with a velocity of 10 mm/min. Ultimate failure load, displacement of 100N, displacement of 400N, stiffness and mode of failure were recorded respectively. Resnlts The maximum load for the Intrafix fixation group was （719. 094 ± 160. 478 ） kg·m·s^-2 significantly higher than that of the bioabsorbable interference screw fixation group [ （476. 640 ± 64. 226） kg·m·s^-2 , P 〈0. 05]. The displacement levels of 100 kg·m·s^-2 and 400 kg·m·s^-2 for the Intrafix fixation group was （1. 025 ±0. 326） mm and （4. 728 ± 1. 992） mm respectively, not significantly different from those of the bioabsorbable interference screw fixation [ （ 1.335 ±0. 539） mm and （7. 564 ±4. 307） mm respectively, t = 0. 2173, 0. 0944, both P 〉 0. 05] , and the stiffness of the Intrafix fixation group was （96. 770 ± 36. 848） kg·m·s^-2 not significantly different from that of the bioabsorbable interference screw fixation group [ （63. 976±31. 003 kg·m·s^-2） , t =0. 0967,P 〉0. 051. After randomized t-test of significance, the displacement levels of 100N and 400N of these 2 groups were not significantly different. Conclusion Both tibial site fixation with bioabsorbable interference screw and that with Intrafix in ACL reconstruction with 4-s

关 键 词：前交叉韧带 生物力学 修复外科手术 

分 类 号：R686[医药卫生—骨科学]