膝关节后交叉韧带重建中等长点测定

TESTING FOR ISOMETRY DURING RECONSTRUCTION OF TH E POSTERIOR CRUCIATE L IGAMENT

目的 测定膝关节后交叉韧带重建中其股骨附丽部上的等长点。方法 取 7侧正常成人新鲜膝关节标本 ,切除后交叉韧带 ,在其股骨附丽部上选前、后、中、近、远五个测试点 ,用细软钢丝将各点与胫骨附丽部中点相连 ,将标本固定于 CPM功能锻炼器上 ,用百分表测量膝关节 0°～ 12 0°活动范围内各钢丝关节内长度的变化。结果 比较各点的钢丝在关节内长度变化的最大值 ,发现前测试点变化最大 ,远点次之 ;近测试点变化最小 ,而近、中两点无显著性差异 ,中、后两点亦无显著性差异 ,但近、后两点有显著性差异 ;近、中、后三点的钢丝关节内长度的最大值均不超过 2 m m。结论 在后交叉韧带重建中 ,应以其股骨附丽部上缘的中点 (即本实验中的近测试点 )为中心钻孔 ,建立股骨骨隧道。术中根据需要 ,可将钻孔中心向中点和后缘偏移。

Objective To measure the isometric point of the attachment site in femur during the recon- struction of posterior cruciate ligam ent (PCL ) . Methods Seven fresh knee specim ens from cadavers were adopted in this experiment. The anterior,posterior,proxim al,distal and central points of the PCL 's femoral attachment site were respectively anchored to the m iddle of the PCL 's tibial attachment site by the trial isom eter wires. The length changes of the intra- articular part of the wires were recorded while the knee was flexed from 0°to 12 0°by a continuous passive m otion(CPM) m achine. Results The m aximal length changes in every points were com pared. It showed that the length change in anterior point was the biggest,the distal point was less than that of anterior point,and the proximal point was the least. There was significant difference between proxim al and posterior points,but no significant difference between proximal and central points,neither between central and posterior points. All of the maximal length changes of proxim al,central and posterior points were not greater than 2 m m . Conclusion The femoral tunnel for the PCL reconstruction should be located at the proxim al point,which is the middle point of upper edge of femoral attachment site.The selected point for femoral tunnel also m ay be moved slightly in the direction to central or posterior points according to the needs of operation.