膝关节后纵隔解剖特点及其在关节镜手术中的应用

ANATOMIC FEATURES OF POSTERIOR SEPTUM OF KNEE JOINT AND ITS APPLICATION IN POSTERIOR TRANS-SEPTAL PORTAL FOR ARTHROSCOPIC SURGERY

目的总结膝关节后纵隔解剖特点及其在关节镜手术中,尤其是跨后纵隔通路建立中的应用。方法查阅近年国内外有关膝关节后纵隔及膝关节镜的文献,并进行归纳分析。结果后纵隔上部血管、神经较丰富,在胫骨平台水平与腘动脉紧邻;将膝关节后室分为较小的外室和较大的内室。膝关节镜下建立跨后纵隔通道时应屈膝90°,方向由外向内,从后纵隔中间靠下部穿过较安全。结论跨后纵隔通道使膝关节镜应用范围大大扩展,但通道建立方法并不统一,只有综合考虑后纵隔解剖学特点,才能减少手术并发症。

Objective To summarize the anatomic features of the posterior septum of the knee joint and its application in posterior trans-septal portal for arthroscopic surgery. Methods The literature related to posterior septum of the knee joint and arthroscopic surgery was extensively reviewed and analyzed. Results The posterior septum of the knee joint has more mechanoreceptors and blood vessels in the upper part, which are close to arteria popliteal at the tibial plateau level; the posterior compartment is divided into wider posteromedial and narrower posterolateral compartments. A safe arthroscopic trans-septal portal is established, in the knee flexion of 90°, in a lateral-to-medial direction, and with an inserting location below the middle of posterior septum. Conclusion The establishment method of posterior trans-septal portal is not uniform and all the features of posterior septum should be considered to decrease the complications.