关节镜下双臂万向瞄准器的研制与临床应用

Design and clinical application of an arthroscopic universal aiming device for cruciate ligament reconstruction

目的自行设计在关节镜下重建膝十字韧带时用于韧带附着点定位的瞄准器,并将该瞄准器应用于临床。方法根据经过球面上任何一点垂直于球面的线均经过球心的基本原理,设计出用于重建十字韧带手术时韧带附着点定位的瞄准器。将其用于关节镜下重建后十字韧带手术12例。结果术后随访5～19个月,平均12.1个月。12例患者按照Lysholm膝关节韧带损伤的评分标准,术前平均59.2分,术后平均92.7分,提高了33.5分。Lachman试验全部转为阴性。膝关节活动度平均120°。结论该瞄准器设计合理、定位准确、操作简便,特别是能从膝关节后内侧入路进行后十字韧带重建时胫骨附着点的定位,解决了关节镜下后十字韧带重建时胫骨端附着点定位的困难,是理想的关节镜下重建十字韧带时附着点的定位工具。

Objective To design an arthroscopic universal aiming device for cruciate ligament repairing and evaluate its clinical efficacy. Methods The aiming device was designed on the principle of “a line crossing any point on a spherical surface and perpendicular to it must cross the sphere center”, which enables the surgeon to locate the ligamentous attachment of cruciate ligament precisely for reconstruction. Twelve cases of PCL injuries have been treated with this method. Results The average follow up period was 12.1 months (5-19 months). According to Lysholm scoring system, the average score was improved from 59.2 points to 92.7 points, increased by 33.5 points. Lachman test turned negative in all patients, the average range of motion was 120°. Conclusion The instrument was reasonably designed for easy handling and precise orientation. It is particularly preferable to locate the tibial attachment of cruciate ligament for endoscopic reconstruction on the posteromedial approach.