前交叉韧带解剖单束重建中股骨止点的临床应用研究

Clinical study of the positioning femoral attachment in the anatomical single-bundle reconstruction of anterior cruciate ligament

目的研究前交叉韧带(ACL)的解剖学特点,探寻ACL解剖单束重建中理想的股骨止点定位方式,并应用于临床,比较其与传统单束重建方式的术后近期疗效。方法观察30例成人尸体膝关节标本ACL纤维在膝关节不同屈曲角度时的张力变化,探寻解剖特点,分析测量相应数据和规律,拟订理想的解剖单束重建股骨止点定位方法;在100例ACL损伤并行单束重建手术治疗的患者中,术前随机抽取50例患者(实验组)根据解剖学研究结果定位股骨止点,另50例患者(对照组)采取传统等长重建方式定位股骨止点,比较两组患者术前及术后Lysholm评分、KT-2000关节测量仪检查及术后并发症等相关指标。结果所有患者术后获得12个月的随访,比较两组患者在术后3个月、术后12个月的Lysholm评分和KT-2000检查显示,实验组均优于对照组,差异有统计学意义(P<0.05)。结论关节镜下ACL解剖单束重建近期临床疗效优于传统等长单束重建。

Objective To study the anatomical characteristics of the anterior cruciate ligament(ACL),and to explore the ideal femoral stasis location method in anatomic single-bundle reconstruction of ACL,and apply it to the clinic to compare the short-term effect of the traditional single-bundle reconstruction.Methods 30 adult cadaveric knee joint specimens were studied to observe the tension changes of ACL fibers at different flexion angles of knee joints,to explore the anatomical features,and to measure the corresponding data.Through the statistical research to find the rule,to formulate the ideal location method about the anatomy of the single beam reconstruction femoral check point;Among the 100 patients who were treated with ACL injury and single-beam reconstruction surgery,50 patients(experimental group)were randomly selected preoperatively to locate the femoral check point according to the anatomical research results,and 50 patients(control group)were selected to locate the femoral check point by traditional equal-length reconstruction.Lysholm score,KT-2000 joint measurement instrument examination and post-operative complications and other relevant indicators of the two groups were compared both before and after surgrey.Results All patients were followed up for 12 months after surgery,and Lysholm score and KT-2000 examination of the two groups were different at 3 months after surgery and 12 months after surgery,the experimental group is superior to the control group,which is truly statistically significant(P<0.05).Conclusion ACL anatomical single-beam reconstruction under arthroscopy has a better short-term clinical efficacy than traditional equal-length single-beam reconstruction.