摘要
目的研究三维-CT(3D-CT)重建技术在单束前交叉韧带(ACL)解剖重建术后检查中的应用效果。方法回顾性分析惠州市中心人民医院2018年4月至2020年1月收治的100例ACL撕裂患者的临床资料,所有患者均给予关节镜下单束ACL解剖重建术治疗,术后进行3D-CT重建图像,术后12个月按照Lysholm评分分为优良组71例和不良组29例。采用X线片及3D-CT测定胫骨和股骨骨道位置,并比较两种方法测定的结果;比较优良组与不良组患者采用3D-CT测定的胫骨和股骨骨道内口位置及移植物情况。结果3D-CT测量的胫骨骨道内口位置为(46.83±2.15)%,明显大于X线的(40.18±3.39)%,差异有统计学意义(P<0.05);3D-CT测量的股骨骨道内口位置为(37.95±2.17)%,明显小于X线的(43.75±3.02)%,差异有统计学意义(P<0.05);预后优良组与不良组患者的3D-CT测定的股骨骨道内口位置分别为(38.09±2.19)%、(37.61±2.12)%,差异无统计学意义(P>0.05),而不良组患者的3D-CT测定的胫骨骨道内口位置为(50.85±2.49)%,明显大于优良组的(45.19±2.01)%,差异均有统计学意义(P<0.05);不良组患者3D-CT测定的移植物长度为(27.68±2.67)mm,明显短于优良组的(32.19±3.84)mm,矢状位夹角为(52.37±5.11)°,明显小于优良组的(56.01±5.82)°,差异均有统计学意义(P<0.05),而两组患者的冠状位夹角比较,差异无统计学意义(P>0.05)。结论3D-CT重建术能够为单束ACL解剖重建术后提供准确的影像学评价,清晰显示移植物和骨道情况,指导手术方案的改进。
Objective To study the application of 3 D-CT(3 D-CT)reconstruction technique in the examination of single bundle anterior cruciate ligament(ACL)after anatomical reconstruction.Methods The clinical data of 100 patients with ACL tear admitted to Huizhou Central People’s Hospital from April 2018 to January 2020 were analyzed retrospectively.All patients were treated with arthroscopic single-bundle ACL anatomical reconstruction,and 3 D-CT reconstruction images were performed after operation.At 12 months after operation,the patients were divided into good group and bad group according to Lysholm score.X-ray film and 3 D-CT were used to measure the position of tibia and femur bone canal,and the position of tibia and femur bone canal inner mouth and graft measured by 3 D-CT were compared between good group and bad group.Results The position of tibial canal opening measured by 3 D-CT was(46.83±2.15)%,which was significantly higher than(40.18±3.39)%measured by X-ray(P<0.05);the position of femoral canal opening measured by 3 D-CT was(37.95±2.17)%,which was lower than(43.75±3.02)%measured by X-ray(P<0.05);there was no significant difference in the position of the inner mouth of femoral canal measured by 3 D-CT in patients with good prognosis and poor prognosis for(38.09±2.19)%versus(37.61±2.12)%(P>0.05).However,the position of the inner mouth of tibial canal measured by 3 D-CT in patients with poor group was(50.85±2.49)%,which was significantly higher than(45.19±2.01)%in good group(P<0.05);the graft length measured by 3 D-CT in patients with adverse group was(27.68±2.67)mm versus(32.19±3.84)mm of good group;the sagittal angle of the bad group was(52.37±5.11)°,which was significantly lower than(56.01±5.82)°of the good group(P<0.05);there was no significant difference in coronal angle between the two groups(P>0.05).Conclusion 3 D-CT reconstruction can provide accurate imaging evaluation after single-bundle ACL anatomical reconstruction,clearly show the graft and bone canal,and guide the improvement of surgica
作者
吴志钧
张理选
WU Zhi-jun;ZHANG Li-xuan(Department of Medical Imaging,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,CHINA;Department of Joint Surgery,Orthopedic First Area,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第8期1007-1010,共4页
Hainan Medical Journal
关键词
三维-CT重建技术
单束前交叉韧带解剖重建术
骨道定点
关节镜
膝关节功能
3D-CT reconstruction technology
Anatomical reconstruction of single bundle anterior cruciate ligament
Fixation of bone canal
Arthroscopy
Knee joint function
