负荷条件下前交叉韧带的股骨重建位置

The femoral inserted position of ACL reconstruction under loading condition

目的 探讨模拟生理负荷条件下前交叉韧带股骨等距重建位置。方法 7具新鲜冷冻膝关节标本 ,在前交叉韧带股骨附着区取 5点以及胫骨附着区中点分别钻骨隧道 ,通过钢丝和等距测量器施加初负荷 ,检测膝关节屈曲过程中胫骨和股骨隧道间的距离变化。结果 膝关节 0°～ 90°屈曲过程中 ,股骨韧带附着区中点、后点和下点与胫骨附着区中点间呈等距变化 ,而股骨韧带附着区前点和上点与胫骨附着区中点间距离变化超过生理等距界限。结论 股骨韧带附着区后点和下点是理想的前交叉韧带股骨等距重建点。股骨韧带附着区中点、后点和下点的连线构成了前交叉韧带的股骨等距重建区。

Objective To investigate the femoral inserted position of anterior cruciate ligament (ACL) isometric reconstruction under simulating physical loading condition. Methods Seven fresh-frozen cadaveric knees were used to drill tunnels, five in the femoral insertion and one in the center of tibial insertion of the ACL, respectively, and loaded by wire and isometer. The magnitude of change in separation distance between a constant point in the tibial insertion of the ACL and five positions within the femoral insertion were measured while the knee was taken through a range of motion. Results The mean changes in separation distance between each of the central, posterior and inferior positions within the femoral insertion of the ACL and the central point in the tibial insertion were isometric while the knee was flexed from 0 degree to 90 degrees, but the anterior and superior positions could not yield such physical isometric change. Conclusions The posterior and inferior positions in the femoral insertion are the optimal location of ACL isometric reconstruction. An isometric reconstructive area could be determined among the central, posterior and inferior positions in the femoral insertion.