腘绳肌腱移植股骨侧不同固定方法重建ACL的生物力学研究

目的探讨腘绳肌腱重建前交叉韧带（ACL）股骨侧不同固定方法的生物力学特性。方法新鲜冰冻尸体膝关节32具,采用四股腘绳肌腱移植重建ACL,随机分为四组,在股骨侧分别采用Endobutton、Rigidfix、肌腱结和界面螺钉固定,测量循环载荷后位移、100N位移、400N位移、失效载荷、最大载荷,计算抗拉刚度。结果失效载荷和最大载荷Endobutton〉Rigidfix〉肌腱结〉界面螺钉固定,Endobutton和Rigidfix之间差异有统计学意义（P〈0.01）,Rigidfix和界面螺钉之间的差异有统计学意义（P〈0.05）,Rigidfix和肌腱结、肌腱结和界面螺钉之间差异无统计学意义;循环载荷后位移肌腱结〉Rigidfix〉Endobutton〉界面螺钉固定、各组间在100N位移、400N位移和抗拉刚度的比较中无统计学差异。结论腘绳肌腱重建ACL股骨侧四种固定方法均可满足ACL重建后的力学需求,Rigidfix固定在循环载荷后的位移、抗拉刚度及固定强度等方面具有一定的生物力学优势。

Biomechanics of different fixation methods for anterior cruciate ligament reconstruction with hamstring tendon grafts on femur

Objective To study the biomechanics of different fixation methods for reconstruction of anterior cruciate ligament（ACL） with hamstring tendon grafts on femor. Methods ACL was reconstructed with 4 hamstring tendon grafts for 32 knee joints of freshly frozen cadavers and fixed with Endobutton, Rigidfix, Hamstring tendon knot, and interface screws, respectively. The displacement at 100N and 400N, failure load, and maximal load were measured to calculate the stiffness after cycling load was detected. Results The maximal load and failure load of Endobutton were the highest followed by those of Rigidfix, Hamstring tendons knot, and interface screws（P〈0.01, P〈0.05）. No significant difference was found in the fixation strength of rigidfix, hamstring tendons knot and interface screws, as well as in displacement at loon and 400N, stiffness. Conclusion The 4 different fixation methods can meet the biomechanics of reconstructed ACL with hamstring tendon grafts on fermur. The displacement and stiffness as well as the fixation strength of rigidix have certain advantages in biomechanics.