带血管蒂髌韧带修复前交叉韧带损伤：计算机导航辅助关节镜的应用

BACKGROUND: The standard angle between the coronal level of tibial tunnel and the joint surface is 65°-70°. The larger angle is easy to cause impacts, and inversely, the medial joint surface of the tibia plateau will be worn.OBJECTIVE: To investigate the application and effects of patellar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combined with arthroscopy.METHODS: Forty patients with anterior cruciate ligament injury were selected, and randomly allotted into two groups (n=20 per group). Patients in traditional surgery group underwent reconstruction by the operator’s experiences, and patients in combination surgery group received the patellar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combinied with arthroscopy, both based on the same location standard. Subsequently, patients underwent CT continuous CT scans, and the tibial tunnel of anterior cruciate ligament was measured to compare the reconstruction effects.RESULTS AND CONCLUSION: The tibial tunnel and femoral tunnel positions in the combination surgery group were significantly higher than those in the traditional surgery group (P < 0.05). The Lysholm scores in the combination surgery group were significantly higher than those in the traditional surgery group at 3, 6 and 12 months after surgery (P < 0.05). Compared with the traditional surgery group, the number transmission times was significantly decreased in the combination surgery group (P < 0.05). Furthermore, sagittal CT and three-dimensional CT results showed that, in the combination surgery group, the posterior wall of the tibial tunnel closely adhered to the rear cortical bone of the proximal tibia with a distance of < 2 mm; a mild rupture appeared at the posterior wall excit of the 1/3 proximal tunnel in traditional surgery group. These results suggest that anterior cruciate ligament reconstuction under computer assisted navigation system combined with arthroscopy achieves satisfactory effects on location of the femoral tunnel. The use of navigation virtual probe avoids the subjective location by surgeons; therefore, it is feasible for clinical treatment.中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Patellar ligament with vascular pedicle for anterior cruciate ligament reconstruction: the intraoperative use of computer assisted navigation system combinied with arthroscopy