腘绳肌腱移植物重建后交叉韧带股骨侧不同固定 - 第三军医大学学报.doc

应用复合固定技术后交叉韧带重建中股骨侧“锐角效应” 目的 探讨股骨侧“锐角效应”及复合固定技术对后交叉韧带重建术后移植物的影响。方法 50例猪膝关节，随机分为5组，以猪的屈趾肌腱作为移植重建后交叉韧带。移植物固定方法分别采用：EndoButton、可吸收界面螺钉(螺钉分别固定在移植物前上方及后下方)、复合固定（EndoButton联合小号界面螺钉）且螺钉固定在移植物后下方。在移植物与骨道边缘之间放置压敏片，并对其施以352N的负荷作用来测定其与骨道边缘之间压强。然后再对各移植物施以屈服负荷。记录各组压强值及屈服负荷。结果 各组间的压强值以及屈服负荷有差异（P0.01）。其中，复合固定组压强值（3.28±0.22 Mpa）低于其它各组，但是屈服负荷（470±55 N）大于其它各组。并且，螺钉固定在后下方压强值（3.22±0.13 Mpa）明显小于前上方固定（3.49±0.27 Mpa）。结论 应用复合固定技术重建后交叉韧带，可以减小“锐角效应”，并且复合固定技术固定强度大于单纯皮质外固定及单纯界面螺钉固定。　后交叉韧带；股骨；复合固定；锐角效应decrease the “critical corner” of femur in posterior cruciate ligament reconstruction with combine fixation YAN Chang-bao, CHEN Bai-cheng, ZHAO Bao-hui, SUN ran, LIU hu. (Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China ) Corresponding author: CHEN Bai-cheng, e-mail: chenbch2001@ Abstract Obievtive To explore the “critical corner” of femur and moreover, to evaluated the combine fixation in Posterior cruciate ligament reconstruction. Methods 50 porcine knee, to divided 5group, randomly. Using the porcine flexor digitorum tendon as graft, to reconstructed Posterior cruciate ligament. The methods of graft fixation are: extracortical fixation, biodegradable interference screw fixation（the fixation location of interference screw is front-upward and rear-inferior）, combine fixation(EndoButton combine small biodegradable interference screw) with the fixation location of interference screw is rear-inferior. To put press-sensitive slice between the ligament graft and the bone tunnel edge for evaluate the pressure between the ligament graft and bone tunnel edge. The load abute 352N was applied to the specimen for calculative pressure. Than the yield load was applied to the specimen for the biomechanical data. Results The pressure and yield load of all group is difference（P0.01）. The pressure of combine fixation is the smallest（3.28±0.22 Mpa）of all the reconstruction group ,and the yield load is the biggest（470±55 N）. And the pressure of rear-infe