膝关节后外侧角重建术中股骨隧道定位对移植物等距性的影响

目的探讨膝关节后外侧角重建术中,股骨隧道定位的变化对移植物等距性的影响。方法选用9具新鲜冷冻尸体膝关节标本,分别在外侧副韧带和腘肌腱股骨侧附着部上选取中、近、远、前、后各5个测试点。模拟膝关节后外侧角的重建步骤,将外侧副韧带、腘肌腱和腘腓韧带胫腓侧的附着部中心与相应股骨侧的5个测试点用铜丝连接,测量膝关节在0°～90°屈曲过程中铜丝长度的变化。结果外侧副韧带股骨侧附着部的远点和前点与其腓骨附着部中心之间变化平均值的最大值均不超过3 mm,且两点无统计学差异(P>0.05);腘肌腱股骨侧附着部的前点与PFL腓骨附着部中心之间变化平均值的最大值不差过3 mm;腘肌腱股骨侧5个测试点与胫骨侧腘肌肌腱移行处点之间变化平均值的最大值均超过3 mm。结论在腓骨侧骨隧道选择附着部中心的情况下,重建外侧副韧带和腘腓韧带时,股骨侧骨隧道宜定位外侧副韧带和腘肌腱附着部前缘(即前点)。

Effects of femoral tunnel placement on the isometry of grafts in PLC reconstruction

Objective To explore the influence of femoral tunnel placement on the isometry of grafts in the recon-struction of posterolateral corner of the knee(PLC).Method Knee specimens from 9 frozen human cadavers were used in the study.Five points of femoral attachment sites,including the central,proximal,distal,anterior and posterior points,were selected as femoral test points for both lateral collateral ligament(LCL)and popliteus tendon(PT).The fibular/tibial attachment sites of LCL,PT and popliteofibular ligamen...