摘要
目的探讨膝关节前交叉韧带(ACL)前内束及后外束股骨止点的解剖位置,找到确定ACL前内束和后外束股骨止点的简单可行的方法,为双束重建ACL手术中的股骨骨道定位提供理论支持。方法解剖18个新鲜膝关节标本(25～45岁)的股骨端前内束和后外束的足迹,以标定前内束和后外束股骨止点中心点的位置。在屈膝90°位,测量ACL前内束及后外束股骨止点中心点距股骨髁间窝外侧壁前方、后方和下方软骨缘的距离。再对测量数据进行评估和对比。结果 ACL后外束股骨止点中心点距离股骨前方软骨缘(8.55±1.33)mm,距离股骨后方软骨缘(8.65±1.54)mm,二者间无统计学差异(t=-0.191,P>0.05);而ACL后外束股骨止点中心点距离股骨下方软骨缘(5.11±0.79)mm。ACL前内束股骨止点中心点距离股骨前方软骨缘(14.95±2.06)mm,距离股骨后方软骨缘(6.08±0.88)mm,二者间有统计学差异(t=16.633,P<0.01);而ACL前内束股骨止点中心点距离股骨下方软骨缘(9.10±1.55)mm。结论膝关节屈膝90°时,ACL后外束的股骨止点中心点位于股骨髁间窝外侧壁距离下方软骨缘5mm的高度,并处在与前方和后方软骨缘几乎等距的位置。而ACL前内束的股骨止点中心点位于股骨髁间窝外侧壁距离下方软骨缘9mm的高度,并处在前后连线大约后1/3的位置。在ACL双束重建的手术中,应用本研究的结果能够简单、快捷地确定ACL前内束和后外束股骨骨道位置。
Objective To investigate the anatomy of the femoral position of posterolateral and anteriomedial bundles of anterior cruciate ligament, and to provide a simple guideline for establishing accurate positioning of the femoral bone tunnels for anteriomedial bundle （AMB） and posterolateral bundle （PLB） during double-bundle ACL reconstruction. Methods 18 cadaveric knees, aged from 25 to 45 years, were dissected, and the footprints of AMB and PLB were marked, so as to locate the footprint centers of AMB and PLB. With the knees flexed at 90°, the following six distances were measured： the distances from femoral footprint centers of AMB and PLB to the posterior,anterior and inferior cartilage borders of the lateral intercondylar wall respectively. The data （mean±standard deviation） were evaluated and compared. Results When the knee was flexed at 90°, the distance from PLB footprint center to anterior cartilage border was （8.55±1.33） mm, and it was （8.65±1.54） mm to the posterior cartilage border,there was no significant difference between these two distances （t=-0.191,P〈0.05）; while it was （5.11±0.79） mm to the inferior cartilage border of the lateral intercondylar wall. The distance from AMB footprint center to anterior cartilage border was （14.95±2.06） mm, and it was （6.08±0.88） mm to the posterior cartilage border, there was significant difference between these two distances （t=16.633,P〈0.01）; while it was （9.10±1.55） mm to the inferior cartilage border of the lateral intercondylar wall. ConclusionsThe results showed that the femoral footprint center of PLB is at the middle of the line joining the anterior and the posterior cartilage borders, and at the height of 5 mm to the inferior cartilage border of the lateral intercondylar wall; the femoral footprint center of AMB is approximately at the one third posterior of the line joining the anterior and the posterior cartilage borders, and at the height of 9 mm to the inferior cartilage border of the lateral interc
出处
《中华关节外科杂志（电子版）》
CAS
2012年第1期63-67,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
北京大学医学部"985"工程Ⅱ期项目(985-2-028-24)
关键词
前交叉韧带
关节镜
解剖
膝关节
Anterior cruciate ligament
Arthroscopy
Dissection
Knee joint
