不同方法移植重建膝前交叉韧带的实验研究

目的探讨自体髌韧带移植重建前交叉韧带(ACL)的固定方法及即刻固定强度。方法将15具标本分为3组,分别为1/3骨-髌韧带-骨(1/3B-PT-B)挤压螺钉固定组,1/3骨-髌韧带Krackow双锁边缝合组和原始标本ACL组。对标本施行单轴拉伸,运用生物力学方法检测分析。所有实验均在液压万能材料试验机(WE-5A)上进行,用数字试应变仪(YJ-14)读取应变,用KG-101高精度数显光栅位移测微仪测量位移。加载速率为1.4mm/min,由于实验均为单轴拉伸试验,故载荷轴向、加载速率和加载等级三者均保持一致。从零加载至韧带撕裂、断裂时为止。达到极限强度过程须全面记录。结果1/3B-PT-B置换挤压螺钉固定组强度、刚度均高于原始标本ACL组及1/3骨-髌韧带Krackow双锁边缝合组,差异有显著性意义(P<0.05)。结论选用1/3B-PT-B置换挤压螺钉固定重建ACL,术后替代物强度高,关节稳定性较好。

A biomechanical investigation of reconstruction of anterior cruciate ligament

Objective To investigate two fixation methods for reconstruction of anterior cruciate ligament(ACL)with autogenous patellar tendon graft and their instant stability.Methods 15 specimens were divided into three groups.The first group was treated with 1/3 bone-patellar ligament-bone replacement and in terference screw fixation,the second group was treated with 1/3 bone-patellar ligament and Krackow locked bilateral suture,and in the third group the intact ACL was not treated.The mono-axial tensile tests were performed on a versatile hydraulic material testing machine(WE-5A)to compare the linear load,maximum load,linear straining,maximum straining,linear displacement,maximum displacement,rupture displacement,destructive energy,elastic modulus,and ultimate strength of ACL in the three groups.Results The ACL stability and rigidity in the group of 1/3 bone-patellar-bone replacement and interference screw fixation were higher than those in the other two groups.The differences between test results were statistically significant.Conclusion The ACL reconstruction with 1/3 bone-patellar ligament-bone replacement and interference screw fixation is a good method to ensure higher strength of graft and better joint stability.