单束单隧道及双束双隧道重建膝前交叉韧带生物力学对比探究.docVIP

单束单隧道及双束双隧道重建膝前交叉韧带生物力学对比探究 　 作者：张文强，王成琪，唐胜建，耿树岩 【关键词】 膝关节 　　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(Pgt;005)；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(Plt;005)。在屈膝角度lt;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(Plt;005)：但屈曲超过60°胫骨移动的距离与完整标本接近(Pgt;005)；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(Pgt;005)。［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。 　　关键词：膝关节； 前交叉韧带； 双隧道重建； 生物力学 　　Abstract：［Objective］To study the outcome of the technique of doubletunnel with doublebundle 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°（Pgt;005), but above 30°, especially 60°, the distance of tibial translation was longer obviously than that of intact specimen (Plt;005). 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 (Plt;005), but above 60°, the distance of tibial translation was similar to that of intact specimen(Pgt;005). At the different flexion degree(0°～90°), the distance of tibial translation was similar to that of intact specimen by using the technique of dou