计算机术前规划软件辅助前交叉韧带重建的疗效观察  

EFFECTIVENESS OF COMPUTER-ASSISTED PREOPERATIVE PLANNING SYSTEM IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

作　　者：何川[1] 李彦林[1] 张振光[2] 王国梁[1] 王福科[1] 曹树海[1] 王慧建[1] 赵沣凯 

机构地区：[1]昆明医科大学第一附属医院运动医学科,昆明650032 [2]昆明医科大学第一附属医院医学影像科,昆明650032

出　　处：《中国修复重建外科杂志》2013年第12期1432-1436,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：云南省科技厅国际合作计划资助项目(2013IA004);云南省科技厅社会发展项目(2009CA020);云南省学术技术带头人后备人才项目(2009CI035)~~

摘　　要：目的探讨自主研发的计算机术前规划软件ACLDetector辅助前交叉韧带（anteriorcruciateligament，ACL）重建的可行性及疗效。方法2009年3月一2012年1月，将80例符合选择标准的ACL损伤患者纳入研究。患者随机分为两组，其中40例采用计算机术前规划软件ACLDetector进行术前设计（试验组），40例采用传统方法（对照组）；两组均于关节镜辅助下完成自体胭绳肌腱移植ACL单束解剖重建。两组患者性别、年龄、病程、致伤原因及术前Lysholm评分、国际膝关节文献委员会（IKDC）评分比较，差异均无统计学意义（P〉0．05），具有可比性。比较术后两组Lachman试验、轴移试验以及Lysholm、IKDC评分，并行MRI重建膝关节三维模型评定ACL移植物与股骨髁问窝是否存在撞击。结果两组患者术后切口均I期愈合，无早期相关并发症发生。患者均获随访，试验组随访时间18～25个月，平均20个月；对照组18～24个月，平均21个月。术后18个月，两组Lysholm及IKDC评分均较术前显著提高（P〈0．05），两组间比较差异均无统计学意义（P〉0．05）；两组Lachman试验及轴移试验显著优于术前（P〈0．05），两组间比较差异亦无统计学意义（P〉0．05）。MRI测量示试验组1例（2．50％）、对照组8例（20．00％）发生撞击，两组问撞击发生率比较差异有统计学意义（X2=4．51，P=0．03）。结论计算机术前规划软件ACLDetector能成功辅助ACL重建术，术后膝关节功能评分与传统手术相似，但在降低ACL术后撞击发生率方面优于传统手术。Objective To evaluate the feasibility and effectiveness of computer-assisted preoperative planning system--ACL Detector in anterior cruciate ligament （ACL） reconstruction. Methods Between March 2009 and January 2012, 80 patients with ACL rupture received arthroscopic ACL single-bundle reconstruction with autologous hamstring tendon transplantation. Before operation, the preoperative planning was done by computer-assisted preoperative planning system-- ACL Detector （trial group, n=40） or by conventional method （control group, n=40）. There was no significant difference in gender, age, disease duration, injury cause, preoperative Lysholm score, and preoperative International Knee Documentation Committee （IKDC） score between 2 groups （P 〉 0.05）. After operation, the effectiveness was evaluated by Lachman test, pivot shift test, Lysholm score, and IKDC score; the digital three-dimensinal model of knee was reconstructed, and the impingement rate of ACL graft was measured. Results All incisions healed by first intention, and no complication was found. The patients were followed up 18-25 months （mean, 20 months） in trial group and 18-24 months （mean, 21 months） in control group. The Lysholm score and IKDC score were significantly increased at 18 months after operation when compared with preoperative scores （P 〈 0.05）, but no significant difference was found between 2 groups （P 〉 0.05）. The results of Lachman test and pivot shift test at 18 months after operation were significantly better than those before operation in 2 groups （P 〈 0.05）, but no significant difference between 2 groups after operation （P 〉 0.05）. MRI showed that impingement was observed in 1 case of trial group （2.50%） and in 8 cases of control group （20.00%）, showing significant difference （X2=4.51, P--0.03）. Conclusion The computer-assisted preoperative planning system--ACL Detector could be successfully applied to ACL reconstruction. It has the same improvement in knee functional score a

关 键 词：计算机辅助技术 术前设计 前交叉韧带重建 

分 类 号：R687[医药卫生—骨科学]