关键词: 前交叉韧带重建, 双骨道, 三骨道, 双束, 生物力学, 医学植入物

Abstract:

BACKGROUND: Arthroscopic anterior cruciate ligament reconstruction can effectively solve the symptoms of knee instability caused by anterior cruciate ligament injury, while double-tunnel double-bundle (single tibia tunnel-single femoral tunnel) and three-tunnel double-bundle (single tibia tunnel-double femoral tunnel) anterior cruciate ligament reconstruction are common repairing methods in clinic.
OBJECTIVE: To investigate the effect of double-tunnel double-bundle and three-tunnel double-bundle anterior cruciate ligament reconstructions on the instability of knee joint.
METHODS: Eight fresh-frozen human cadaveric knee specimens were selected and treated with double-tunnel double-bundle and three-tunnel double-bundle anterior cruciate ligament reconstructions respectively, and the instability of knee joint under an anterior tibial load (134 N) and internal tibial torques load (5 N•m) at 0°, 15°, 30°, 60 ° and 90 °of flexion were tested using MTS-809 biomechanics test system.
RESULTS AND CONCLUSION: ①Anterior tibial load: the displacement of two reconstruction groups under five angles stated above were larger than that of anterior cruciate ligament intact group, and the difference was not significant (P > 0.05); while the anterior tibial replacement in double-tunnel double-bundle anterior cruciate ligament reconstruction group was larger than that in the three-tunnel double-bundle anterior cruciate ligament reconstruction group, and the difference was not significant (P > 0.05). ②Tibial torques load: under five angles stated above, the anterior tibial replacement of anterior cruciate ligament intact group was smallest, and there was no significant difference of anterior tibial replacement under 0°, 15° and 90° flexion between double-tunnel double-bundle anterior cruciate ligament reconstruction group and three-tunnel double-bundle anterior cruciate ligament reconstruction group (P > 0.05), while the anterior tibial replacement under 30° and 60° flexion in the three-tunnel double-bundle anterior cruciate ligament reconstruction group was smaller than that in the double-tunnel double-bundle anterior cruciate ligament reconstruction group, and the difference was significant (P < 0.05); there was no significant difference of anterior tibial replacement between three-tunnel double-bundle anterior cruciate ligament reconstruction group and anterior cruciate ligament intact group (P > 0.05). The anterior-posterior and rotational stability of knee joint could be improved by double-tunnel double-bundle and three-tunnel double-bundle anterior cruciate ligament reconstructions. But compared with double-tunnel double-bundle anterior cruciate ligament reconstruction, three-tunnel double-bundle anterior cruciate ligament reconstruction can effectively provide more rotational stability of knee joint.