前交叉韧带重建股骨足迹精确定位的解剖与临床研究

摘要/Abstract

摘要：

目的　探讨前交叉韧带（ACL）个性化解剖重建术中韧带止点足迹精确定位的方法及效果。方法　①15侧膝关节尸体标本，标记ACL股骨足迹，观察ACL足迹长轴与股骨干角度、前内束（AM）中心位点距后软骨缘距离、后外束（PL）中心位点距下软骨缘距离。②15例行ACL重建患者，术中采用三入路观察与导航定位方法明确ACL股骨足迹，测量AM与PL连线与股骨干夹角、AM距后软骨缘距离、PL距下软骨缘距离。结果　15例膝关节尸体标本ACL股骨足迹长轴与股骨干角度为（18.5±　2.5）°、AM与股骨外髁内面后缘距离为（6.1±1.8）mm、PL距离下软骨缘距离为（6.2±2.2）mm，但每个标本均不相同。导航显示，ACL股骨足迹长轴与股骨干夹角为（19.3±3.1）°，AM与股骨外髁内面后缘为（5.8±1.2）mm、PL距离下软骨缘为（5.9±2.5）mm，各数据相差较大。结论　①ACL股骨与胫骨解剖足迹变异较大，应根据每例ACL足迹不同进行精确的个性化解剖重建。②以同一个标准进行所有ACL重建难以达到真正的解剖重建。

关键词: 前交叉韧带, 足迹, 个性化, 精确定位, 临床解剖

Abstract:

Objective　To study the pinpoint of footprint during the individual in-situ reconstructing of anterior cruciate ligament(ACL).　Methods　The footprints of femur were detected on 15 healthy knee specimen, and 15 cases with ACL rupture and underwent ACL reconstruction procedure by navigation. The angle between the axis of ACL footprint and the shaft of femur, the distance from the center of AM to posterior margin of femoral condyle, PL to the inferior margin of cartilage were detected, both in specimen and ACL reconstruction cases.　Results　The angle between the axis of ACL footprint and the shaft of femur was about （18.5±2.5）° and (19.3±3.1）° for specimens and patients respectively; The distance from the AM to medial surface of lateral condyle of femur was (6.1±1.8）mm and （5.8±1.2）mm; The distance from PL to the edge of inferior cartilage was about （6.2±2.2）mm and （5.9±2.5）mm respectively; The values of parameter were different for different samples and cases.　Conclusions　The footprints of ACL on the femur and the tibia are variant both in specimens and patients. During in-situ ACL reconstruction procedure, individual ACL footprint measurement should be performed.

Key words: Anterior cruciate ligament, Footprint; , Individual, Pinpoint, Clinical anatomy

中图分类号:

R687.4

陆伟, 王大平, 肖德明. 前交叉韧带重建股骨足迹精确定位的解剖与临床研究[J]. 中国临床解剖学杂志, 2011, 29(5): 513-516.

LIU Wei, WANG Da-Beng, XIAO De-Meng. Anatomy and clinical investigation on the pinpoint of footprint in the in-situ anterior cruciate ligament reconstruction[J]. Chinese Journal Of Clinical Anatomy, 2011, 29(5): 513-516.

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