三维CT对前交叉韧带重建术后骨道的早期评估  

Early Assessment on Bone Tunne of Anterior Cruciate Ligament I Reconstruction by Three-Dimensional Compute Tomography

作　　者：李丹[1] 赵其纯[1] 尚希福[1] 胡飞[1] 贺瑞[1] 杨万荣[1] 

机构地区：[1]安徽医科大学附属省立医院骨二科,安徽合肥230001

出　　处：《实用骨科杂志》2016年第2期130-133,共4页Journal of Practical Orthopaedics

基　　金：安徽省科技厅重点科研项目(11070403044)

摘　　要：目的评估三维CT对单束前交叉韧带（anterior cruciate ligament,ACL）重建术后膝关节临床价值及早期效果。方法收集我院2014年2月至2015年1月间在关节镜下重建前交叉韧带重建患者46例。ACL损伤患者均采用前内侧入路（anteromedial portal technical,AM）单束重建前交叉韧带,术后2~7 d内给予患者多层螺旋CT扫描,在此基础上进行三维CT重建,观察关节内移植物、股骨及胫骨骨隧道及内固螺钉等结构情况。结果三维CT能够清晰显示前交叉韧带重建术后关节内移植物、股骨及胫骨骨隧道及内固定螺钉等情况。术后切口均Ⅰ期愈合、无感染,术后随访1、3、6个月,观察术后膝关节功能,用Lysholm评分对患者手术前后进行评分,Lysholm评分术前（52.51±9.26）分,术后随访1个月Lysholm评分（67.70±7.78）分,差异具有统计学意义（t=13.87,P〈0.001）。结论多层螺旋CT及三维重建能够清晰的显示前交叉韧带重建术后关节内移植物及骨道情况,是对前交叉韧带重建术后情况评估的重要方法,为临床提供较为准确的影像学评价方法和回顾性指导关节镜术中骨道定位。Objective To evaluate three-dimensional compute tomography of early effect on one single bundle anterior crueiate ligament （ACL） reconstruction of the knee joint and the clinical value. Methods Anterior cruciate ligament recon- struction by anteromedial portal technical （AM） was used to repair 46 patients of ACL injury in our hospital from February 2014 to January 2015. After 2 -7 days ,the following measurements were observed through 3D-CT：the bone tunnel in tibia and femur, the bone anatomical landmark, the Endobutton, the bone block, interference screw fixing, materials in bone tunnel. Re- suits Three-dimensional compute tomography could clearly show joint cruciate ligament reconstructive surgery grafts, femoral and tibial tunnels and fixation screws, etc. All operation incisions were healed in I stage without infection. Preoperative and postoperative Lysholm scores were recorded, postoperative knee joint activity were observed. The patients were followed up 1,3 and 6 months. The Lysholm score for the operated knees were （52.51 ± 9.26 ） and （67.70± 7.78 ） , respectively before and after operation （ t = 13.87, P 〈 0. 001 ）. Conclusion Three-dimensional compute tomography can provide useful information for clinics and be served as an important approach for early follow-up after anterior eruciate ligament reconstruction due to its accurate display of graft shape, bone tunnel and the locations of internal fixation. It is an important method for anterior cruciate ligament reconstruction surgery assessment to provide more accurate imaging method for clinical evaluation.

关 键 词：前交叉韧带 重建 三维CT 评估 

分 类 号：R684[医药卫生—骨科学]