经胫骨隧道重建前交叉韧带过程中等长点的确定

背景：前交叉韧带重建中等长点的选择较为关键，关于经前内侧关节镜入路及经胫骨隧道重建前交叉韧带过程中等长点确定的问题讨论类研究较少。目的：观察经前内侧关节镜入路及经胫骨隧道重建前交叉韧带的疗效并讨论等长点的确定的技术问题。方法：纳入前交叉韧带损伤的患者48例，查体及磁共振检测显示前交叉韧带完全断裂，随机分为经前内侧关节镜入路组26例和经胫骨隧道入路组22例。结果与结论：随访平均21个月，结果显示经前内侧关节镜入路及经胫骨隧道重建前交叉韧带重建中选择等长点次数差异均无显著性意义。两组Lysolm 评分、Tegner评分和移植物角度a差异均无显著性意义(P > 0.05)。提示采用经胫骨入路建立股骨侧隧道，利用重建中选择等长点的方法，可获得与经前内侧关节镜入路相近的临床结果。

Isometric point selection of anterior cruciate ligament reconstruction with anteriomedial arthroscopic approach and transtibial approach

BACKGROUND:It is important to select the proper isometric point of anterior cruciate ligament (ACL) reconstruction procedures. Isometric point selection of ACL reconstruction with anteriomedial arthroscopic and transtibial approach is rarely reported.OBJECTIVE:To evaluate the clinical results and discuss technical issues of isometric point selection of ACL reconstruction with anteriomedial arthroscopic and transtibial approach．METHODS:From 2007-2010, 48 cases of ACL rupture of our department were included in this research. All patients complainted of knee instability after injury and their ages were between 18-55 years. Physical exam and MRI revealed complete tear of the ligament. The patients regained 0-120°range of motion and no inflammatory or trauma was reported on skin of their knees. Patients were randomly divided into anteriomedial arthroscopic approach group (n=26) and transtibial approach group (n=22). They were technically studied to review the clinical results and the difference of femoral tunnel building between these two approaches. RESULTS AND CONCLUSION:The average follow-up duration was 21 months. Times for isometric point selection of ACL reconstruction with anteriomedial arthroscopic and transtibial approach were 1.80±0.25, 2.20±0.18, respectively. No significantly difference was found. Lachmann scores, Tegner scores, and angle of grafts were not significantly different between the two groups (P > 0.05). Using anteriomedial arthroscopic approach and isometric point determination methods, transtibial approach could yield similar clinical results with anteromedial approach.