不同定位方法对单束前交叉韧带重建术中股骨隧道的影响  

Effect of different location methods on femoral tunnel in anterior cruciate ligament reconstruction

作　　者：宋恩鸿[1] 邹国耀[1] 刘瑞端[1] 李靳杨 SONG Enhong;ZOU Guoyao;LIU Ruiduan;LI Jinyang(Department of Spinal and Osteopathy Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, China)

机构地区：[1]桂林医学院附属医院脊柱骨病外科,广西桂林市541001

出　　处：《微创医学》2019年第1期31-34,共4页Journal of Minimally Invasive Medicine

摘　　要：目的比较两种股骨隧道定位方法对前交叉韧带重建术中股骨隧道的影响。方法收集采用自体腘绳肌行单束前交叉韧带重建术的80例患者为观察对象,随机分为经胫骨定位股骨隧道组(TT组)和经前内侧定位股骨隧道组(AM组),每组40例。记录术中股骨隧道的长度,测量并计算术后X线上股骨隧道在冠状位、矢状位的角度和股骨止点距Blumensaat线的相对位置,并行统计学分析。结果 TT组股骨隧道长度为(47. 13±6. 78) mm,明显长于AM组的(42. 10±4. 65) mm(P <0. 05)。TT组和AM组股骨隧道在冠状位角度分别为(53. 33±6. 68)°、(45. 25±4. 93)°,在矢状位的角度分别为(44. 45±8. 59)°、(37. 13±6. 52)°,两组间比较,差异有统计学意义(P <0. 05)。TT组和AM组股骨止点的相对位置分别为(61. 22±6. 09)%、(65. 01±4. 83)%,两组间比较,差异有统计学意义(P <0. 05)。结论与TT技术相比,AM技术建立的股骨隧道更短,角度更小,更容易定位于前交叉韧带的解剖足迹上,实现韧带的等长重建。Objective To compare the effect between two location methods on femoral tunnel in anterior cruciate ligament reconstruction.Methods A total of 80 patients undergoing single-bundle anterior cruciate ligament reconstruction with hamstring autografts were selected as subjects,and were randomly divided into femoral tunnel using transtibial approach group(TT group)and femoral tunnel using anteromedial portal group(AM group),with 40 cases in each group.The length of femoral tunnel was recorded during operation,the angle of femoral tunnel in the coronal and sagittal views and the relative position of femoral termination away from Blumensaat line were measured and calculated in X-ray images after operation,and then statistical analysis was performed.Results The femoral tunnel length of the TT group was significantly longer than that of the AM group[(47.13±6.78)mm vs.(42.10±4.65)mm,P<0.05].The angles in coronal/sagittal views of the TT group and the AM group were(53.33±6.68)°/(44.45±8.59)°and(45.25±4.93)°/(37.13±6.52)°respectively,and statistical differences were observed between the two groups(P<0.05).The relative positions of the femoral termination were(61.22±6.09)%and(65.01±4.83)%in the TT group and the AM group respectively,and statistical difference was observed between the two groups(P<0.05).Conclusion Compared with the TT technique,the femoral tunnel established by AM technique obtains shorter length and smaller angle,can be located on the anatomical footprint of the anterior cruciate ligament more easily,and achieves equal length reconstruction.

关 键 词：前交叉韧带 重建 股骨隧道 定位方法 Blumensaat线 

分 类 号：R686.5[医药卫生—骨科学]