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目的探讨前交叉韧带(ACL)单束解剖重建股骨隧道与外侧副韧带(LCL)重建股骨隧道的关系,以期为临床中ACL解剖重建提供解剖学数据,便于临床实际操作中避免2个股骨隧道相互干扰,为ACL和LCL一期解剖重建提供依据。方法采用30例成人尸体膝部标本,保留膝关节上下至少20cm,排除关节明显退变、畸形及关节损伤。男性16例,女性14例,年龄在23~66岁,平均年龄38.7岁。屈膝120°经前内辅助入路(AMP)钻取股骨隧道。在股骨外髁外侧面寻找后外侧角(PLC)结构,钝性分离LCL,并钻取LCL隧道。标本进行CT扫描,在CT片上观察隧道碰撞数,并计算两个隧道的最短距离。结果在LCL股骨隧道深度为25mm时,其与ACL股骨隧道最短距离为(3.9±2.4)mm;在LCL股骨隧道深度为30mm时,其与ACL股骨隧道最短距离为(2.7±1.9)mm。在ACL股骨隧道深度为25mm时,其与LCL股骨隧道的最短距离为(4.4±2.6)mm;在ACL股骨隧道深度为30mm时,其与LCL股骨隧道的最短距离为(3.2±2.1)mm。在30例标本中,共发现6例隧道碰撞,碰撞的几率高达20%。结论我们发现两者隧道发生碰撞的几率高,临床一期解剖重建时,术前应做个体化准备,规划好LCL重建所需股骨隧道的长度和隧道直径,从而规避与ACL股骨隧道的碰撞。
Objective To explore the relationship between single anterior cruciate ligament (ACL) anatomical reconstruction of the femoral tunnel and lateral collateral ligament (LCL) reconstruction of the femoral tunnel in order to provide anatomical data for clinical ACL anatomy and reconstruction, to facilitate the clinical practice to avoid two femoral tunnels Interference, providing the basis for the first stage anatomical reconstruction of ACL and LCL. Methods Thirty adult cadaver knee specimens were used to keep the knee joint at least 20cm above and below the joint, and to exclude obvious joint degeneration, deformity and joint injury. 16 males and 14 females, aged from 23 to 66 years with an average age of 38.7 years. Torsion 120 ° through the anterior approach (AMP) to drill femoral tunnel. Lateral femoral condyle in search of posterolateral horn (PLC) structure, blunt LCL, and drill LCL tunnel. The specimens were scanned by CT, observed the number of tunnel collisions on the CT slice, and calculated the shortest distance between the two tunnels. Results The shortest distance between LCL femoral tunnel and ACL femoral tunnel was (3.9 ± 2.4) mm when the depth of LCL femoral tunnel was 25mm. The shortest distance between LCL femoral tunnel and ACL femoral tunnel was (2.7 ± 1.9) mm at the depth of 30mm. The shortest distance between ACL and femoral tunnel was (4.4 ± 2.6) mm at ACL depth of 25 mm and the shortest distance between ACL and femoral tunnel was (3.2 ± 2.1) mm at depth of 30 mm. In 30 specimens, a total of 6 tunnel collisions were found, with a collision probability of up to 20%. Conclusions We found that there was a high probability of collisions between the two tunnels. During the first phase of clinical anatomy, the length of the femoral tunnel required for LCL reconstruction and the diameter of the tunnel should be planned before surgery to avoid the collision with the ACL femoral tunnel.