预拉力对腘绳肌腱结嵌压法重建前交叉韧带固定强度的影响

目的探讨预拉力对腘绳肌腱结嵌压固定方法重建前交叉韧带稳定性的影响。方法18只新鲜冷冻猪膝关节离断后用阶梯形钻头成型股骨隧道为倒置的酒瓶状,自体腘绳肌腱打结后呈双股穿过并嵌压在瓶颈口,实验分三组,分别以50N、100N及200N拉力预拉三次,在生物材料实验机上进行拔出实验。结果50N预拉组,400N位移高于其他两组,抗拉刚度低于另两组(P<0.01),最大载荷与100N预拉组没有显著性差异(P>0.05),但高于200N预拉组(P<0.01);100N预拉组与200N预拉组只在最大载荷上有显著性差异(P<0.01),在400N位移及抗拉刚度上两组没有显著性差异(P>0.05)。结论腘绳肌腱结嵌压固定前给予不同的预拉力,对破坏载荷、位移及抗拉刚度均产生不同影响;预拉力在100N至200N时,抗拉刚度明显提高,且对最大载荷无明显影响。

The Influence of the Preload on the Stability of Anterior Cruciate Ligament Reconstruction by Hamstring Tendon Knot Embedding Method

Objective To study the influence of the preload on the stability of anterior cruciate ligament reconstruction by hamstring tendon knot embedding method. Methods Eighteen fresh frozen porcine distal femurs were drilled to form bottleneck-like bone tunnels. A knot was tied in the middle part of the hamstring tendons, and the double-stranded tendons were inserted and embedded in the bone tunnel. The tendons were preloaded at 50N?100N and 200N three times respectively before test. Pull-out experiments were performed on bio-material test machine. Results In 50N preload group, the displacement of 400 Newton load was higher than the other two groups and the stiffness was lower than the other two. The maximum load was similar with the 100N group (P>0.05), but higher than 200N group (P<0.01). There was no statistically significant difference between the 100N preload group and 200N preload group with regard to 400N displacement and stiffness (P>0.05). Conclusions The preload has an impact upon peak load?displacement and stiffness in hamstring tendon knot embedding fixation. When the preload was applied between 100 Newton and 200 Newton, the stiffness increased significantly, whereas the maximum load decreased slightly.