ACL重建股骨隧道定位及固定方法研究  

Positioning of the Femoral Tunnel and Fixation in Anterior Cruciate Ligament Reconstruction with Arthroscop

作　　者：赵斌[1] 邢更彦[1] 刘运晃[1] 白晓东[1] 姜川[1] 王振宇[1] 

机构地区：[1]武警总医院关节四肢科,北京100039

出　　处：《实用骨科杂志》2009年第7期502-506,共5页Journal of Practical Orthopaedics

基　　金：国家自然科学基金项目(30371430)

摘　　要：目的探讨关节镜下应用半腱肌、股薄肌肌腱重建膝前交叉韧带时股骨隧道定位及固定方法。方法经临床及膝关节镜检查诊断的膝前交叉韧带损伤者86例采取镜下修复,分别应用经由内向外及由外向内2种定位方法行股骨隧道定位;股骨隧道固定分别应用Endobutton、Rigidfix及可吸收挤压螺钉3种方法。结果经随访10～26个月,Lachman征、前抽屉试验均为阴性,Lysholm评分从28分到70分,平均56.65分。结论股骨端隧道由内向外定位方法（通过胫骨隧道）创伤略小,适用于Endobutton、Rigidfix等,但受胫骨隧道位置及角度影响,要使股骨端隧道定位点与前交叉韧带股骨外髁解剖止点完全吻合,必须建立精确位置及角度的胫骨隧道。而股骨端隧道由外向内定位方法创伤略大,适用于股骨端挤压螺钉固定,定位点不受胫骨隧道影响,与前交叉韧带股骨外髁解剖止点较易吻合;而各种股骨端固定方法各有利弊,选择最佳的股骨隧道及固定方法将有助于减少术后并发症。Objective To investigate the selection of isometric points and bone tunnel＇s angel in anterior cruciate ligament（ACL）reconstruction using quadrupled semitendinosus tendon and gracilis tendon under arthroscope. Methods Eighty-six patients with rupture of ACL were diagnosed through clinical and arthroscopic examination. Two techniques of femoral tunnel location（transtibial tunnel and outside-in）and three types of fixation were applied. Results Patients were followed up averagely for 10 to 26 months. According to Lysholm knee scale scoring,the average knee scores were 28 and 56.65 respectively before and after operation（P〈0.05）. Conclusion Various femoral tunnel location and fixation methods have their own strengths and weaknesses. Selecting the best femoral tunnel location and fixed method will help reduce post-operative complications.

关 键 词：前交叉韧带重建 股骨隧道定位 内固定 

分 类 号：R684[医药卫生—骨科学]