前交叉韧带损伤对膝关节侧副韧带影响的运动还原在体稳定性研究  

Effect of anterior cruciate ligament injury on lengths of knee collateral ligaments

作　　者：李凭跃[1] 尹庆水[1] 黄华扬[1] 李鉴轶[2] 沈洪园[1] 王泽锦[1] 王庆[1] 

机构地区：[1]广州军区广州总医院全军创伤骨科中心,510010 [2]南方医科大学广东省重点生物力学实验室

出　　处：《中华创伤骨科杂志》2010年第7期659-663,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（30600302）

摘　　要：目的 对前交叉韧带（ACL）损伤膝关节侧副韧带长度变化进行运动还原在体稳定性研究.方法 2008年1月至6月收治8例单侧膝关节ACL断裂而对侧膝关节止常的患者,男6例,女2例;平均年龄25.3岁;在生理负重膝关节屈曲0°、15°、30°、60°和90°时采集相互垂直的二维（2D）图像,与三维CT（3D）图像在虚拟X线投射系统进行2D/3D图像配准,还原膝关节不同角度时股骨和胫骨的相对三维位置关系,并通过韧带止点还原的方法对内侧副韧带（MCL）、外侧副韧带（LCL）进行韧带长度分析,对比两侧膝关节侧副韧带的长度差异.结果 ACL损伤后在0°、15°和30°患膝MCL长度分别为（40.16±1.63）、（39.11±1.77）、（37.86±1.84）mm,健膝分别为（38.17±1.40）、（37.63±1.37）、（36.60±1.86）mm,健、患膝比较差异均有统计学意义（P〈0.05）;ACL损伤后在0°、15°和30°患膝LCL长度分别为（50.23±1.18）、（50.30±1.68）、（49.26±1.67）mm,健膝分别为（52.56±1.64）、（52.30±1.48）、（51.83±1.77）mm,健、患膝比较差异均有统计学意义（P〈0.05）.ACL损伤后60°和90°健、患膝MCL、LCL长度差异均无统计学意义（P〉0.05）.结论 通过2D/3D图像配准技术可以实现膝火节的运动还原并获得ACL损伤后生理屈曲过程中MCL和LCL的长度变化规律.在0°、15°和30°,ACL损伤后患膝MCL长度较健膝增加,而LCL长度较健膝缩短.Objective To study the effect of anterior cruciate ligament（ACL）injury on lengths of the medial collateral ligament（MCL）and the lateral collateral ligament（EEL）at weightbearing flexion by the technique of 2D/3D registration. Methods Eight volunteers with unilateral ACL rupture and a normal cantralateral knee were enrolled in this study.Their CT（3D）images and 2D orthogonal images of the knee were taken at weightbearing flexions of 0,15°,30°,60°and 90°.These orthogonal images were used to recreate the in vivo knee positions at each of the targeted flexion angles by the method of 2D/3D registration.The lengths of MCL and LCL were measured and compared through recreation of the bone insertions of MCL/LCL. Results At 0,15 and 30 degrees,the mean MCL lengths of the ACL injured knee were respetively（40.16±1.63）,（39.1 1±1.77）and（37.86±1.84）mm,longer than those of a normal knee （38.17±1.40）,（37.63±1.37）and（36.60±1.86）mm.But the mean LCL lengths of the ACL injured knee were respectively（50.23±1.18）,（50.30±1.68）and（49.26±1.67）mm,shorter than those of a normal knee（52.56±1.64）,（52.30±1.48）and（51.83±1.77）mm.All the difierences were statistically significant（P〈0.05）. Conclusions We can measure the in vivo lengths of MCL and LCL of an ACL injured knee by the technique of 2D/3D registration.At 0,15°and 30°,the MCL length of an ACL injured knee is longer than that of a normal knee,but the LCL length of an ACL injured knee is shorter than that of a normal knee.

关 键 词：膝关节 前交叉韧带 侧副韧带 稳定性测试 

分 类 号：R686[医药卫生—骨科学]