骨性标志定位与测量定位在前交叉韧带重建中股骨骨道位置对比研究  

Acomparative study of the position of the femoral tunnel in anterior cruciate ligament reconstruction between using bony landmark and measuring method

作　　者：董岩[1] 周敬滨[2] 崔鹏[1] Dong Yan;Zhou Jingbin;Cui Peng(Department of Orthopedics,Beijing Tongren Hospital,Capital Medical University,Beijing100730,China;National Institute of Sports Medicine,Beijing 100061,China)

机构地区：[1]首都医科大学附属北京同仁医院骨科,北京100730 [2]国家体育总局运动医学研究所,北京100061

出　　处：《中国运动医学杂志》2024年第10期771-776,共6页Chinese Journal of Sports Medicine

摘　　要：目的:前交叉韧带(anterior cruciate ligament,ACL)解剖重建手术中,观察分别使用骨性标志法和测量定位法进行股骨侧定位的骨道位置分布情况,以探寻更好的ACL股骨侧定位方法。方法:回顾性分析2016年10月至2021年7月因ACL断裂于我科进行关节镜下ACL单束解剖重建手术的90例患者资料。股骨骨道参考住院医师嵴和分叉嵴进行定位的患者,设为骨性标志组(n=34),男26例、女8例,左膝19例、右膝15例,年龄30.8±4.6岁;股骨骨道采用测量尺测量进行定位的患者,设为测量方法组(n=56),男42例、女14例,左膝32例、右膝24例,年龄31.7±5.3岁。在三维CT股骨侧位视图上绘制矩形框,根据骨道中心点在此矩形框的深-浅方向及高-低方向上所占比例而定位骨道位置,比较两组骨道位置在各方向的分布情况及骨道位置良好程度。结果:股骨骨道位置分布:股骨外髁深-浅方向偏后、正常、偏前的例数,骨性标志组分别为4、23、7例,测量方法组分别为7、47、2例;高-低方向偏高、正常、偏低的例数,骨性标志组分别为22、11、1例,测量方法组分别为6、48、2例;两组比较差异均有统计学意义(P<0.01)。骨道位置良好比例:骨性标志组26.5%,测量方法组80.4%,差异具有统计学意义(P<0.01)。结论:与使用骨性标志法定位相比,采用测量定位法进行骨道定位解剖重建ACL,股骨侧骨道位置更加集中于正常范围,骨道位置良好率有所改善。Objective To observe the distribution of bone tunnel positions in anterior cruciate ligament(ACL)anatomic reconstruction surgery using the bony landmark method and the measuring method for femoral positioning,respectively,so as to explore better positioning methods for ACL on the femoral side.Methods The data of 90 patients who underwent arthroscopic ACL single-bundle anatomical reconstruction surgery in our department between October 2016 and July 2021 were analyzed retrospectively.Patients with the femoral tunnel localized according to the resident’s ridge and the bifurcate ridge were selected into the bony landmark group(n=34),including 26 males and 8 females(19 left knees,15 right knees,and aged 30.8±4.6 years)while those with the femoral tunnel localized using ruler measurements were chosen into the measuring method group(n=56),consisting of 42 males and 14 females(32 left knees and 24 right knees,aged 31.7±5.3).A rectangular frame was drawn on the three-dimensional CT lateral view of the femur,and the bone canal position was located accord ing to the proportion of the bone canal center point in the deep-shallow direction and the high-low direction of the rectangle frame.The distribution of the position in each direction and the degree of the tunnel position were compared between the two groups.Results In the deep-shallow direction in femoral epicondyle,4,23 and 7 of the bony landmark method group were of the posterior,normal and anterior position,showing significant differences from those of the measuring method group(7,47 and 2).Moreover,significant differences were also observed in the number of patients with high/normal/low positions in the high-low direction,which was 22/11/1 in the bony landmark method group and 6/48/2 in the measuring method group(P<0.01).Meanwhile,the percentage of good bone tunnel positioning in the bony landmark method group was 26.5%,significantly lower than the measuring method group of 80.4%(P<0.01).Conclusion In anatomical reconstruction of the ACL,the measuring method is s

关 键 词：ACL断裂 解剖重建 骨性标志 测量定位 

分 类 号：R687.4[医药卫生—骨科学]