自制等长测试工具在关节镜下前交叉韧带重建术中应用的效果观察  

Effect of self-made isometric testing tool in arthroscopic anterior cruciate ligament reconstruction

作　　者：卢海燕[1] 赵达锋 陈剑 范华强 LU Haiyan;ZHAO Dafeng;CHEN Jian;FANG Huaqiang(Department of Orthopdics,Xiamen Hongai Hospital Affiliated to Fujian Medical University,Xiamen,Fujian 361000,China;不详)

机构地区：[1]福建医科大学附属厦门弘爱医院骨科,福建厦门361000 [2]中国人民解放军陆军第七十三集团军医院骨科二区,福建厦门361000

出　　处：《中国骨与关节损伤杂志》2025年第2期145-150,共6页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价自制等长测试工具在关节镜下前交叉韧带重建术中定位股骨隧道内口的准确性,总结应用技巧并提出改进方案。方法回顾性分析自2022-01—2023-06采用关节镜下前交叉韧带重建术治疗的19例前交叉韧带损伤,术中将直径2.4 mm螺钉捆上2号强生缝线,经前内侧入路置入,尾线从胫骨隧道引出,此时拉紧尾线屈伸膝关节,观察尾线长度变化,如果长度变化小于2 mm即可认为该股骨隧道内口合适,如果长度不满意则微调位置测试,直至找出最满意的类等长点。结果术中2例第1次定点时屈伸伸缩<1 mm。9例第1次定点屈伸伸缩≥1~2 mm,微调位置再测试1次选位置更优处。8例第1次定点屈伸伸缩>2 mm,第2次定位时5例屈伸伸缩<2 mm;3例进行第3次定位,其中2例屈伸伸缩<2 mm,1例屈伸伸缩>2 mm。19例均获得随访,随访时间3~12个月,平均9.6个月。随访期间无韧带松弛及韧带再断裂发生。末次随访时膝关节功能Lysholm评分为81.1~88.2分,平均84.7分;膝关节IKDC评分为78.1~84.8分,平均81.4分;Lachman试验中胫骨相对于股骨出现前移0.66~6.20 mm,平均3.43 mm。结论关节镜下前交叉韧带重建术中应用自制等长测试工具可以提前测试股骨隧道内口定点是否符合类等长,等长测试工具制作简易且操作简单,可重复性好,无需较长的学习曲线,值得临床推广应用并进一步完善设计。ObjectiveTo evaluate the accuracy of the self-made isometric testing tool in locating the internal opening of the femoral tunnel during arthroscopic anterior cruciate ligament reconstruction,and summarize the application skills and propose an improvement plan.MethodsA retrospective analysis was conducted on 19 cases of anterior cruciate ligament injury treated with arthroscopic anterior cruciate ligament reconstruction from January 2022 to June 2023.During the operation,a 2.4 mm diameter screw was tied with a No.2 Johnson suture and inserted through the anteromedial approach.The tail line was led out of the tibial tunnel.At this time,while the tail line was tightened the knee joint was flexed and extended,and the change in the length of the tail line was observed.If the length change was less than 2 mm,the internal opening of the femoral tunnel was considered appropriate.If the length was not satisfactory,the position was fine-tuned for testing until the most satisfactory quasiisometric point was found.ResultsIn 2 cases,the flexion and extension were less than 1mm at the first positioning.In 9 cases,the flexion and extension were≥1-2 mm at the first positioning.The position was fine-tuned and tested again to select the best position.In 8 cases,the flexion and extension were greater than 2 mm at the first positioning.In 5 cases,the flexion and extension were less than 2 mm at the second positioning.In 3 cases,the flexion and extension were less than 2 mm in 2 cases and greater than 2 mm in 1 case.All 19 cases were followed up for 3-12 months(mean 9.6 months).No ligament laxity or ligament re-rupture occurred during the follow-up.At the last follow-up,the Lysholm score of knee joint function was 81.1-88.2 points(mean 84.7 points);the IKDC score of knee joint was 78.1-84.8 points(mean 81.4 points);the anterior displacement of tibia relative to femur in Lachman test was 0.66-6.20 mm(mean 3.43 mm).ConclusionThe use of a self-made isometric test tool during arthroscopic anterior cruciate ligament reconstruction can t

关 键 词：前交叉韧带损伤 前交叉韧带重建 关节镜 自制等长测试工具 类等长 

分 类 号：R686.5[医药卫生—骨科学]