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单束单隧道与双束双隧道重建膝前交叉韧带的生物力学对比研究 被引量:13

Biomechanical comparison of single-versus double-femoral tunnel the anterior cruciate ligament reconstruction technique
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摘要 [目的]研究双束股骨双隧道法重建前交叉韧带(ACL)恢复膝关节前后方向稳定性的能力,并与单束单隧道重建法进行生物力学性能的比较.[方法]应用跟腱分别采用双束股骨双隧道、单前内侧束和单后外侧束三种方法对10个新鲜尸体膝关节进行前交叉韧带重建.术后分别于膝关节屈曲0°、15°、30°、60°及90°时对胫骨施行±100 N的作用力,测量胫骨相对于股骨移动的距离.[结果]在屈膝角度较小(0°~30°)的情况下,单前内侧束重建法术后胫骨的移动距离与完整标本接近(P>0.05);但屈曲超过30°,特别是超过60°后,单前内侧束重建法术后胫骨移动的距离明显大于完整标本(P<0.05).在屈膝角度<60°的情况下,单后外侧束重建法胫骨移动的距离明显大于完整标本(P<0.05):但屈曲超过60°胫骨移动的距离与完整标本接近(P>0.05);在膝关节的整个屈曲范围(0°~90°)内,双束股骨双隧道重建法术后胫骨移动的距离与完整标本接近(P>0.05).[结论]双束股骨双隧道重建法,在膝关节的整个屈曲范围(0°~90°)内,比单束股骨单隧道重建法能更有效的恢复膝关节的稳定性. [ Objective ] To study the outcome of the technique of double-tunnel with double-bundle tendon calcaeus (TE) for reconstruction of the anterior cruciate ligament for recovering the knee stability, and to compare with that of single femoral tunnel in biomechanics. [ Method ] The anterior cruciate ligaments are reconstructed using tendon calcaneus on ten fresh cadaveric knees by using the followed three techniques: double bundles, single anteromedial bundle (AMB) and single posterolateral bundle (PLB) respectively. After operation, force of ± 100 N was applied on tibia and the distance of tibial translation toward thighbone on knee flexion at 0°, 15°, 30°, 60° and 90° was measured. [ Result]The distance of tibial translation was similar to that of intact specimen by using the technique of single AMB when the knee flexion degree was under 30° ( P 〉 0. 05 ), but above 30°, especially 60°, the distance of tibial translation was longer obviously than that of intact specimen ( P 〈 0. 05 ). When the knee flexion degree was under 60° , the distance of tibial translation was longer obviously than that of intact specimen by using the technique of single PLB (P 〈0. 05), but above 60°, the distance of tibial translation was similar to that of intact specimen(P 〉 0. 05 ). At the different flexion degree(0°-90° ), the distance of tibial translation was similar to that of intact specimen by using the technique of double-tunnel with double-bundle ( P 〉 0. 05 ). [ Conclusion] The technique of double-tunnel with double-bundle of TE for reconstruction of anterior cruciate ligament(ACL) can improve the knee stability at the different flexion degree (0°- 90° ) and is more efficiently than the technique of single-tunnel with single-bundle.
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2006年第10期757-759,共3页 Orthopedic Journal of China
关键词 膝关节 前交叉韧带 双隧道重建 生物力学 knee Anterior cruciate ligament Double tunnels reconstruction Biomechanics
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参考文献5

  • 1Tatsuo Mae MD,Konsei Shino MD,Takahide Miyama MD,et al.Single-versus two-femoral socket anterior cruciate ligament reconstruction technique:biomechanical analysis usinga robotic simulator arthroscopy[J].The Journal of Arthroscopic and Related Surgery,2001,17,(7):708 -716.
  • 2徐卿荣,朱振安.前交叉韧带股骨等距重建位置的比较[J].中国矫形外科杂志,2004,12(10):771-773. 被引量:21
  • 3Dienst M,Burks RT,Greis PE.Anatomy and biomechanics of anterior curciate ligament[J].Orthop Clin North (Am),2002,33 (4):605 -620.
  • 4Rizzo M,Holler SB,Bassett FH.Comparison of males' and females'ratios of anterior-cmciate-ligament width to femoral-intercondylarnothwidth:a cadaveric study[J].Am J Orthop,2001,30 (8):660-664.
  • 5陈百成,毛远青,高石军,王飞,邵德成,王晓峰.双束股骨双隧道法重建后十字韧带的实验研究[J].中华骨科杂志,2003,23(5):308-312. 被引量:17

二级参考文献14

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