自体髌韧带重建前交叉韧带后膝关节外侧感觉障碍的研究

目的：研究自体B-P-B中1／3组织重建ACL后膝关节外侧皮肤感觉障碍的发病原因。方法：(1)对21例临床用自体B—P—B中1／3组织重建ACL的患者随访5～6年，测量其膝关节切口外侧皮肤感觉麻木范围。(2)解剖观察成人新鲜尸体标本3具6例和附腐固定的成人尸体标本15具30例的隐神经髌下支的分布范围。结果：术后患者均不同程度的出现膝关节外侧皮肤感觉障碍；隐神经髌下支自深筋膜穿出后，在胫骨内侧髁下方发出分支，横行跨过髌韧带分布至膝外侧皮肤。结论：隐神经髌下支分布到膝外侧皮肤，用自体B-P-B中1/3组织重建ACL在取材时可致其损伤，是术后并发膝外侧皮肤感觉障碍的原因。

The investigation of the etiology of sensory disturbance of the lateral area of the knee after aterior cruciate ligament reconstruction with Bone-patellar tendon-bone tissue

Objective: To study the mechanism of sensory disturbance of the lateral area of knee after the ACL reconstruction with B-T-B tissue. Methods: Twenty-one cases were fellowed-up and the lateral sensory disturbance area of the knee were measured after five years later on operation . The infrapatellar branch of saphenous nerve of three fresh adult cadavers and eleven adult cadavers were dissected and observed. Results: The sensory disturbance of the knee lateral area occurred in every cases after operations; the saphenous nerve Infrapatellar branch passed through the deep fascia, and crossed through the tibial medial epicondyle anteriorly or posteriorly, offset some branches which crossed upon the patellar tendon and distributed to the lateral skin of knee. Conclusions: The saphenous nerve inftrapatellar branch didtributes to the lateral skin of knee and will be cut when the auto-tissue of the B-T-B was obtained. It is that induced the sensory disturbance of the lateral area of the knee after the ACL restructuration.