中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (50): 9387-9390.doi: 10.3969/j.issn.2095-4344.2012.50.014

• 组织构建与生物力学 tissue construction and biomechanics • 上一篇    下一篇

内侧副韧带断裂膝关节内前交叉韧带单束和双束的重建

陈连旭1，王虹虹2   

  • 出版日期:2012-12-09 发布日期:2012-12-09

Single-bundle and double-bundle anterior cruciate ligament reconstruction in the medial collateral ligament-deficient knee

Chen Lian-xu1, Wang Hong-hong2   

  • Online:2012-12-09 Published:2012-12-09

PDF

477

被引次数

2

摘要：

背景：对于前交叉韧带和内侧副韧带复合损伤患者，在保守治疗内侧副韧带、手术重建前交叉韧带时，前交叉韧带重建的手术方式选择存在争议。
目的：在内侧副韧带断裂的膝关节内，观察前交叉韧带单束重建和双束重建的生物力学差别。
方法：将16具成年猪的膝关节随机分为两组，每组8具。膝关节切断内侧副韧带和前交叉韧带后，一组进行前交叉韧带的单束重建，一组进行双束重建。利用Robot分别测量每组膝关节在完整膝关节、内侧副韧带和前交叉韧带切断、前交叉韧带单束重建和双束重建4种状态下不同屈膝角度的胫骨前向位移、内旋和外旋角度。
结果与结论：膝关节切断前交叉韧带和内侧副韧带，可以显著增加胫骨的前向位移和内、外旋转角度。前交叉韧带重建，可以降低胫骨的前向位移和内、外旋转角度。前交叉韧带双束重建在降低胫骨的外旋方面优于单束重建。结果提示对于内侧副韧带和前交叉韧带复合损伤患者，在保守治疗内侧副韧带断裂、前交叉韧带重建时，应优先选择前交叉韧带双束重建，以便更好地控制胫骨的外旋，增加膝关节前内旋转的稳定性。

Abstract:

BACKGROUND: It is controversial that single-bundle and double-bundle anterior cruciate ligament (ACL) reconstruction with conservative treatment of medial collateral ligament (MCL) in the treatment of combined injuries of the ACL and MCL.
OBJECTIVE: To observe the biomechanical difference of single-bundle and double-bundle ACL reconstruction in the MCL-deficient knee.
METHODS: Totally 16 adult pig knees were randomly divided into two groups. The ACL and MCL of the knee was transected, single-bundle ACL reconstruction was performed in one group, and double-bundle ACL reconstruction in another group. The anterior tibial translation (ATT), internal rotation (IR) and external rotaion (ER) of the tibia were measured with Robot in states of intact knee, ACL and MCL transected, single-bundle and double-bundle ACL reconstruction at different knee flexion.
RESULTS AND CONCLUSION: Compared with the intact knee, ATT, IR and ER were significantly increased in the ACL and MCL transected knee. After the ACL reconstruction in the MCL-deficient knee, ATT, IR and ER were significantly restored, and double-bundle ACL reconstruction was superior to single-bundle ACL reconstruction in restoring ER of the tibia. These findings indicate that double-bundle ACL reconstruction is superior to single-bundle ACL reconstruction at restoration of tibial ER stability in the MCL-deficient knee with redard to treatment of combined injuries of the ACL and MCL.