内侧髌股韧带重建术中股骨隧道Schöttle定位法的研究进展  

Research progress of Schöttle’s method for femoral tunnel localization in medial patellofemoral ligament reconstruction

作　　者：魏雨乔 孙重霄 路凡 闫鹏安 夏亚一[1,2,3] WEI Yuqiao;SUN Chongxiao;LU Fan;YAN Peng’an;XIA Yayi(Department of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou Gansu,730030,P.R.China;Orthopaedic Clinical Research Center of Gansu Province,Lanzhou Gansu,730030,P.R.China;Intelligent Orthopaedic Industry Technology Center of Gansu Province,Lanzhou Gansu,730030,P.R.China)

机构地区：[1]兰州大学第二医院骨科,兰州730030 [2]甘肃省骨科临床医学研究中心,兰州730030 [3]甘肃省智能骨科行业技术中心,兰州730030

出　　处：《中国修复重建外科杂志》2024年第12期1524-1529,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(82060405、82360436);兰州市科技计划项目(021-RC-102);甘肃省自然科学基金资助项目(22JR5RA943、22JR5RA956、23JRRA1500);兰州大学第二医院“萃英科技创新”计划(CY2021-MS-A07、CY2022-MS-A19)。

摘　　要：目的对内侧髌股韧带重建术中股骨隧道Schöttle定位法研究进展进行综述,为临床应用提供参考。方法广泛查阅近年国内外Schöttle定位法相关研究文献,并对影响定位准确性的问题及提高定位准确性的新思路进行归纳总结。结果内侧髌股韧带重建术中准确定位股骨隧道很重要,隧道错位是术后并发症发生和手术失败的主要原因。Schöttle定位法是目前研究最深入、可重复性最高的股骨隧道定位方法,是被广泛应用的“金标准”。然而,影响Schöttle定位法准确性的问题仍然存在,包括膝关节内外旋、内外翻会影响定位准确性,X线片拍摄要求和解剖标志参考线绘制标准尚未明确,对于解剖结构变异患者适应性降低,以及对儿童患者缺乏进一步研究。近年来相关研究提出了有望提高Schöttle定位法定位准确性的新思路。结论未来研究应结合3D打印、术中导航等新技术,致力于发展个性化、智能化Schöttle定位法,进一步提高其定位准确性。Objective To review the research progress of Schöttle’s method in medial patellofemoral ligament reconstruction(MPFLR),and provide the latest knowledge and suggestions for surgical treatment.Methods The studies on Schöttle’s method at home and abroad in recent years were extensively collected,then summarized the problems affecting the accuracy of Schöttle’s method and the new ideas to improve the accuracy of localization.Results It’s vital to accurately locate the femoral tunnel during MPFLR.Malposition of the femoral tunnel is the main cause of postoperative complications and surgical failure.Schöttle’s method is the most well studied and most reproducible method for femoral tunnel localization,which is widely used as the“gold standard”.However,there are still problems that affect the accuracy of Schöttle’s method,including the impact of the internal/external rotation and varus/valgus of the knee on localization accuracy,unclear requirements for X-ray imaging and anatomical landmark reference line drawing standards,no suitable for patients with anatomical variations,and lack of further research on pediatric patients.In recent years,some new ideas are proposed to improve the Schöttle’s method to improve the localization accuracy.Conclusion Future research should combine new technologies such as three-dimensional(3D)printing and intraoperative navigation to develop personalized and intelligent Schöttle’s method,further improving their localization accuracy.

关 键 词：内侧髌股韧带 股骨隧道 Schöttle定位法 研究进展 

分 类 号：R687.4[医药卫生—骨科学]