双中点法评估前交叉韧带重建股骨隧道I.D.E.A.L点  

Estimation of the I.D.E.A.L point of anterior cruciate ligament reconstruction of the femoral tunnel by double median point method

作　　者：李腾云 付昌马[1] LI Tengyun;FU Changma(Department of Orthopaedics,The Third People′s Hospital of Hefei,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学合肥第三临床学院合肥市第三人民医院骨科,安徽合肥230022 [2]庐江县人民医院骨科,安徽庐江231501

出　　处：《皖南医学院学报》2024年第5期422-425,共4页Journal of Wannan Medical College

基　　金：合肥市卫健委应用医学研究重点项目(hwk2023zd024)。

摘　　要：目的:建立一种简单有效的以双中点为参考的股骨隧道位置评估方法。方法:选取2021年8月~2022年12月运用自体肌腱类等长重建前交叉韧带(ACL)损伤患者13例,采用双中点法制备股骨隧道I.D.E.A.L点。纳入患者术前物理查体及磁共振检查均提示ACL断裂。比较手术前后国际膝关节文献委员会(IKDC)评分、Lysholm评分、视觉模拟量表(VAS)评分;同时双中点制备股骨隧道的x/t(%)和y/h(%)数值与术后Bernard网格象限的理想位置x/t(%)和y/h(%)数值进行比较。结果:随访3个月,术后第3个月IKDC、Lyshlom评分均较术前上升(P<0.05),而VAS评分较术前下降(P<0.05)。术后膝关节侧位Bernard网格象限x/t(%)和y/h(%)与理想化位置x/t(%)和y/h(%)数值比较差异无统计学意义(P>0.05)。结论:双中点法是ACL重建评估股骨隧道位置的良好方法,术中关节镜测量与术后Bernard网格象限测量具有良好的一致性。Objective:To establish a simple and effective method for location estimation of the femoral tunnel based on double midpoints.Methods:Thirteen patients undergoing anterior cruciate ligament reconstruction using autologous tendon isometric length were included from August 2021 to December 2022.Of the 13 patients,femoral tunnel I.D.E.A.L point was prepared by double midpoint method.Preoperative physical examination and magnetic resonance imaging of the included patients indicated anterior cruciate ligament rupture.Scores of International Knee Documentation Committee(IKDC),Lysholm and VAS were compared before and after operation.Meanwhile,the x/t(%)and y/h(%)values of the double midpoint femur tunnel were compared with the ideal position of the Bernard grid quadrant after surgery.Results:Follow-up in 3 months showed that IKDC scores,Lysholm scores at 3 months after surgery were significantly increased,yet VAS scores were decreased(all P<0.05).There was no significant difference between the lateral Bernard grid quadrant x/t(%)and y/h(%)of knee joint and the ideal position[both x/t(%)and y/h(%)values were 25%](P>0.05).Conclusion:The double median point method appears a good approach to estimating the location of femoral tunnel in anterior cruciate ligament reconstruction.The intraoperative arthroscopic measurement is in good agreement with the Bernard grid quadrant measurement after surgery.

关 键 词：前交叉韧带 单束重建 股骨隧道 I.D.E.A.L点 双中点 评估 

分 类 号：R687.4[医药卫生—骨科学]