知识与财富的链接
目的 探讨膝内侧髌股韧带(MPFL)重建术中股骨隧道定位变化对移植物等距特性的影响.方法 取10具正常成年人新鲜膝关节标本,分辨出MPFL股骨端及髌骨端止点中心0,分别在股骨止点上取收肌结节中点(A)、股骨止点的近点(B)、中点(C)、远点(D)以及股骨内上髁中点(E)5个测试点,测量膝关节屈曲0°、30°、60°、90°、120°时各测试点长度的变化.结果 比较各测试点的长度变化发现,其中收肌结节(A)、股骨止点的近点(B)这两点长度变化较小,且最大值均不超过3 mm.其中对AO和BO进行两两比较,发现无显著性差异(P>0.05).结论 在MPFL重建时应尽量以其股骨端止点的上缘(即近点)为中心建立隧道,根据需要可适当向收肌结节侧偏移.
Objective To explore the influence of positioning of the femoral tunnel for medial patellofemoral ligamentre (MPFL)construction on the isometric characteristics of grafts.Method Knee specimens from ten fresh frozen cadavers were used. The attachment of medial patellofemoral ligament was observed. The distance between points from the adductor tubercle, the medial femoral epicondyle, and proximal, distal and central point of the MPFL’s femoral attachment site respectively to the middle point of its patellar attachment site were measured. Changes in length were recorded while the knee was measured by angles of knee flexion (0°, 30°, 60°, 90°, and 120°). Results The length changes in every point were compared. All of the maximal length changes of its adductor tubercle: proximal points were not greater than 3 mm. There was no significant difference between the length changes of adductor tubercle and proximal points（P>0.05）. Conclusions The position of the femoral turnel for MPFL reconstruction should be located as follows: MPFL should be at the middle point of upper edge of femoral attachment site (proximal point), and the point can appropriately be shifted to adductor tubercle.
