摘要
目的探讨解剖学研究设计关节镜下后外复合体(PLC)重建的手术方案及技术流程。方法通过10例成人膝关节尸体标本设计关节镜下手术重建技术的流程,对PLC组成之一的腘肌复合体的关节镜下解剖特点以及周围相邻解剖结构进行观察和测量。设计显露腘肌腱的股骨附着点和肌腱-肌腹交界点的关节镜入路以及股骨和胫骨隧道的定位与制备方法,完成关节镜下腘肌腱的重建。结果2008年8月至11月间,共采用上述技术完成7例手术。均为多发韧带损伤的患者,受损韧带中包括后交叉韧带(PCL)与PLC损伤。其中的5例术前膝关节外旋较对侧增加15°以上,采用上述技术完成单纯腘肌腱重建,2例外旋增加的同时伴有3度外侧副韧带松弛,在腘肌腱重建的基础上重建外侧副韧带。早期随访结果显示7例患者的外旋均小于或等于对侧。结论根据解剖研究确定腘肌腱远近端的定位标志,通过关节镜技术进行显露及定位,在关节镜下完成腘肌腱的重建手术具有可行性。
Objective This study was conducted for define the detailed anatomical features of popliteus and design for arthroscopie reconstruction technique of posterolateral complex （ PLC ） . Methods Ten fresh-frozen human eacaverie knees were used for observering and measuring the anatomical relationships between popliteus and its surrounding structures. Arthroscopic reconstruction technique and working flow of popliteus tendon （cadaver study） were designed. Arthroseopie portals were designed for exploration and localization of the proximal insertion and distal musculotendoninous junction of popliteus. Femoral and tibial tunnel location, drilling, graft implanation and fixation technique were used to complete the procedure. Results From August 2008 to November 2008, seven patients with multiple ligament injuried under- went PLC surgical reconstruction using above mentioned technique. Among them, five cases with excessive external rotation instability （more than 15 degrees of side-to-side difference） were performed with popliteus reconstruction, another two cases with additional grade Ⅲ varus instability received associated lateral collateral ligament reconstruction. The prilimenary results showed encouraging findings with all of the sevent patients having symmetrical of overconstrained external rotation stability. Conclusions With the anatomical features of popliteus defined from the present cadaveric study, arthroscopie popliteus reconstruction is feasible.
出处
《中华关节外科杂志（电子版）》
CAS
2009年第2期45-49,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节镜
腘肌腱
解剖
Arthroscopy
Popliteus tendon
Dissection
