猪膝关节前交叉韧带重建术中韧带初始移植张力测量最佳位置的确定

Determination of the optimal measuring position for initial graft tension in porcine ACL reconstruction during the operation

目的研究猪膝关节前交叉韧带(ACL)重建后横向测量初始移植张力时的横向拉力-横向位移(F-s)曲线关系,为ACL初始移植张力的最佳测量位置提供实验依据。方法取经预处理后的新鲜的猪膝关节前交叉韧带标本24份,随机分为A、B、C3组,分别进行量韧带固定端、1/4位置和中点位置韧带横向拉力-位移实验,记录横向拉伸位力及速度与对应横向位移值,并绘制力-位移曲线结并分析其结果。结果探钩在中间位置点处拉伸时的F-s曲线斜率较小,1/4位置点处曲线斜率其次,在边缘位置点处的曲线斜率最大。在同一位置测量时,初始张力分别为50、75和100N时的曲线斜率基本上不再变化;在拉伸边缘处位置(A),各力的曲线斜率变化比较混乱;对于拉伸到1/4处位置(B)和中间处位置(C)的实验,不同力的曲线斜率变化就比较规律。不同横向拉伸速度下探钩的位移和所受的力关系曲线大致一致。结论前交叉韧带重建术后初始移植张力测量中点位置最好,术者更容易把握F-s曲线关系和辨别当前韧带张力,而横向拉伸速度对测量结果的影响较小。

Objective To study the F-s curve of transverse tensile and transverse displacement after ACL reconstruction of pig, and to obtain the theoretical basis for the optimal measurement position of initial tension after ACL reconstruction. Methods 24 pig porcine anterior cruciate ligament samples were randomly divided into three groups. Different measuring positions were performed including the edge position,quarter-position and middle position. Different location’s transverse tensile force and speed with the corresponding transverse displacement were recorded. F-s curves were drawn with computer and analyzed. Results The slopes of F-s curve were smaller when the hook were stretched at the middle position of ligament, the curve slopes at 1/4 position of ligament were the second, and the curve slopes at the edge position of ligament were the largest. Measured at the same point with initial tension 50, 75 and 100 N, the slopes of the F-s curve were basically unchanged, but at the edge position of ligament the curve slopes were quite confused(group A). For group B and group C, the curve slopes variation of dif-ferent forces were relatively regular. F-s curves of different transverse speed and corresponding displacement were same approximately. Conclusions After anterior cruciate ligament reconstruction, the middle position is optimal for measuring initial graft tension. It facilitates surgeon to understand the F-s curves relationship and to identify the current ligament tension. The transverse tensile speed has few impact on the result.