后交叉韧带3D模型技术获取低位胫骨隧道解剖参数研究  

Study on anatomical parameters of low tibial tunnel in posterior cruciate ligament reconstruction based on 3D surgical simulation technology

作　　者：陈思捷 郭来威 王遵林 谭念 张康瑞 韵向东[1] 夏亚一[1,2] 滕元君[1,2] Chen Sijie;Guo Laiwei;Wang Zunlin;Tan Nian;Zhang Kangrui;Yun Xiangdong;Xia Yayi;Teng Yuanjun(Department of Orthopedics,Lanzhou University Second Hospital,Lanzhou 730030,China;The Second Clinical Medical College,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院骨科,兰州730030 [2]兰州大学第二临床医学院,兰州730000

出　　处：《中国临床解剖学杂志》2023年第5期505-510,共6页Chinese Journal of Clinical Anatomy

基　　金：兰州大学医学教育创新发展项目(lzuxcx-2022-173/lzuyxcx-2022-97);兰州大学第二医院萃英科技创新计划项目(CY2021-QN-A14);国家级大学生创新创业训练计划(202310730192);甘肃省高等学校创新基金项目(2022B-044)。

摘　　要：目的基于后交叉韧带(posterior cruciate ligament,PCL)3D模型技术建立低位胫骨隧道并测量其解剖参数。方法选取101例健康膝关节CT影像资料,利用Mimics21.0(Materialise,比利时)软件建立PCL 3D虚拟手术模型并建立前内侧与前外侧入路的低位胫骨隧道,测量胫骨隧道长度(length of the PCL tibial tunnel,LTT),胫骨隧道与胫骨平台3D夹角(3D included angle between tibial medial axis extension line and tibial plateau,3D ATPT)以及隧道入口点到胫骨平台距离(perpendicular distance of the tunnel’s entry point to the tibial plateau,PTT)。利用SPSS 25.0进行统计学分析。结果前内侧与前外侧胫骨隧道参数测量,LTT分别为(45.56±4.27)mm、(43.93±4.10)mm,差异有统计学意义(P<0.05);3D ATPT分别为(48.17±6.12)°、(54.49±5.81)°,差异有统计学意义(P<0.05);PTT分别为(61.86±6.80)mm、(63.51±6.32)mm,差异有统计学意义(P<0.05)。结论测量PCL的3D模型低位胫骨隧道相关参数,可为临床PCL重建手术提供理论参考。Objective To establish the low tibial tunnel based on the posterior cruciate ligament(PCL)3D virtual technology to measure its anatomical parameters.Methods CT image data of 101 patients with healthy knee joints were selected,and PCL 3D virtual surgery model was established by using mimics21.0(Materialise,Belgium)software.Low tibial tunnels of anteromedial and anterolateral approaches were established respectively.The anatomical parameters included the length of the posterior cruciate ligament tibial tunnel(LTT),the 3D included angle between tibial medial axis extension line and tibial plateau(3D ATPT)and perpendicular distance of the tunnel’s entry point to the tibial plateau(PTT).SPSS 25.0 was used for statistical analysis.Results The average length of PCL tibial tunnel was greater in the anteromedial group than the anterolateral group was(45.56±4.27)mm versus(43.93±4.10)mm,P<0.05.The average 3D angle between tunnel and tibial plateau was greater in the anterolateral than the anteromedial(54.49±5.81)°versus(48.17±6.12)°,P<0.05.The PTT in the anteromedial group and the anterolateral group were(61.86±6.80)mm and(63.51±6.32)mm,respectively(P<0.05).All the above parameters had statistical differences.Conclusions The parameters related to the low tibial tunnel measured in this study can provide theoretical reference for PCL reconstruction surgery in clinical practice.

关 键 词：后交叉韧带 3D手术模拟 膝关节 胫骨骨道 

分 类 号：R686.5[医药卫生—骨科学]