摘要
[目的]对关节镜下重建前交叉韧带(ACL)手术中,经胫骨隧道与髌下前内侧入路建立股骨隧道的长度、角度进行比较。[方法]在140例ACL移植重建患者中,70例采用经胫骨隧道、70例经前内入路建立股骨隧道,术中记录股骨隧道长度,术后行膝关节前后位及侧位X线检查,测量股骨隧道在冠状面与内外髁连线及矢状面与股骨干轴线夹角,并使用t检验进行统计分析。[结果]经胫骨隧道组及经前内入路组股骨隧道长度分别为(50.67±5.00)mm、(37.97±4.45)mm,后者股骨隧道长度短于前者,差异非常显著(P<0.01);冠状面股骨隧道角度两者分别为68.20°±6.92°;矢状面为45.45°±7.47°、32.81°±9.45°,无论在冠状面及矢状面,前内入路组股骨隧道角度均小于胫骨隧道组,差异非常显著(P<0.01)。[结论]在关节镜下ACL移植重建手术中,采用前内入路制备的股骨隧道,长度短、角度小。它可以减小"雨刮效应"和"蹦极效应"发生的可能,最终获得更好的临床效果。
[ Objective] To compare the length and angle of femoral tunnel which were created by transtibial technique and anteromedial portal technique in arthroscopic anterior cruciate ligament （ACL） reconstruction. [ Method] In 140 cases of ACL reconstruction, femoral tunnel was drilled by transtibial technique in 70 cases, and by anteromedial portal technique in 70 cases. Femoral tunnel length was recorded during surgery and tunnel angles on coronal and sagittal plane were measured on X - ray pho- tos postoperatively. The results had been statistically analyzed by student t test. [ Result ] The mean length of femoral tunnel of group TT was 50.67 ±5.00 mm, whereas, that of group AM was 37.97±4.45 ram. The femoral tunnel length of group AM is sig- nificantly shorter than that in group TT（ P 〈 0.01 ）. In group TT, the coronal angle of femoral tunnel was 68.20±6.92°, where- as, that of group AM was 50.67 ± 6.94°. As for the sagittal angle, in group TT it was 45.45± 7.47° and in group AM 32.81±9.45°. Both coronal angle and sagittal angle in group AM are significantly smaller than that in group TT（ P 〈 0.01 ）. [ Conclu- sion] Compared with TY technique, AM portal technique creates more oblique and shorter femoral tunnel. The short and oblique femoral tunnel may reduce the possibility of ＂windshield wiper effect＂ and ＂bungee effect＂.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第8期746-750,共5页
Orthopedic Journal of China
关键词
前交叉韧带
关节镜检查术
股骨隧道定位
单束
经胫骨的
前内侧入路
anterior cmciate ligament reconstruction, arthroscopy, femoral tunnel placement, single - bundle, tran-stibial, anteromedial portal
