前交叉韧带重建术止点定位的临床研究_临床医学论文.docVIP

前交叉韧带重建术止点定位的临床研究_临床医学论文 前交叉韧带重建术止点定位的临床研究_临床医学论文 【摘要】 ［目的］通过比较不同临床结果下前交叉韧带重建术骨隧道止点位置的差异，探讨理想骨隧道的影像学位置。［方法］选择55例关节镜下前交叉韧带重建术病例，对过伸位X线侧位片测量并分别计算股骨、胫骨止点及Blumensaat线的胫骨平台投影点相对位置。根据临床结果不同分两组对上述资料分析影像表现差别。［结果］股骨侧止点位置在不同临床结果的两组间有显著性差异，胫骨止点位置和Blumensaat线投影点位置组间无差异性。胫骨止点均位于Blumensaat线投影点之后。［结论］股骨侧止点位置偏前临床效果较差，大致位于Blumensaat线距股骨外侧髁前缘交点的65%～69%之间。胫骨侧止点在伸直位Blumensaat线胫骨投影点之后，大致位于胫骨平台前后直径距前缘38%～41%之间。术前进行患膝关节的过伸位X线片检查，并测量Blumensaat线的胫骨投影位置，有助于为术前胫骨止点定位提供参考。 【关键词】 前交叉韧带； 重建； 关节镜； 止点 Abstract：［Objective］To detect the optimal tunnel insertion of arthroscopic reconstruction of the anterior cruciate ligament (ACL) through comparing with the different clinical outcomes.［Method］Fiftymoral tunnel position,the tibial tunnel position and the position of the tibial intersection of Blumensaats line were confirmed by percentage.The tunnel position on the different clinical outcome was analyzed statistically.［Result］There was significant difference (0.05) in femoral attachments of ACL when compared with the different clinical outcome groups.There were no differences (Pgt;0.05) in tibial attachments and the position of the tibial intersection of Blumensaats line between these two groups.The study showed that the position of tibial tunnel was behind the position of the tibial intersection of Blumensaats line.［Conclusion］An excessively anterior femoral tunnel placement will lead to a decline in the clinical result.The better femoral attachment was located on 65%～69% from the anterior end of the Blumensaats line.The position of tibial tunnel was behind the position of the tibial intersection of Blumensaats line,and was situated on average the front 38%～41% of the tibial plateau.The roentgenograms of the extended knee of preoperation is considered help to locate the tibial tunnel. Key words：anterior cruciate ligament; reconstruction; arthroscopy; attachment 随着对前交叉韧带 (anterior cruciate ligament，ACL) 损伤的关节镜下重建技术研究的深入，目前许多学者认为，早期一直争论的移植物选择和固定方式已不再是影响ACL重建手术结果的主要因素，手术技术可能更为重要，这其中骨隧道止点的准确定位尤为关键。关于