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目的在侧位X线片下分别测定膝关节屈曲90°及过伸位时前交叉韧带(ACL)股骨等距点(i点)到胫骨等距点(T点)的距离,并比较在2种体位下其长度的变化,评估关节镜结合X线透视双监视法行ACL等距解剖重建的影像学效果。方法门诊随机抽取50名志愿者,行膝关节侧位X线片检查,在PX电子系统下找到屈曲90°及过伸位ACL的i点和T点,测量两点间距离,并比较在屈伸过程中两点长度的变化。结果屈曲90°时i点到T点距离的95%可信区间为(25.43±0.455)mm,最大值为29.22 mm,最小值为20.29 mm;过伸位时i点到T点距离的95%可信区间为(26.90±0.436)mm,最大值为29.76 mm,最小值为23.10 mm;过伸位与屈曲90°时两点间距离之差的95%可信区间为(1.47±0.204)mm,最大值为3.33 mm,最小值为0.47 mm。结论术前X线片测量及术中关节镜结合X线透视双监视法可根据不同个体的差异对ACL的股骨等距点及胫骨等距点行准确定位,可达到生理性等距重建的要求,同时对设备的要求不高,可在大多数医院开展。
Objective To compare the distance from the equatorial point of anterior cruciate ligament (ACL) to the equidistant point of tibia (T point) at 90 ° and 90 ° flexion of knee joint under lateral radiographs, To evaluate the effect of arthroscopy combined with X-ray double-monitor on the isometric anatomical reconstruction of ACL. Methods Fifty volunteers were randomly selected from the outpatient department to perform lateral X-ray examination of knee joint. The i-point and T-point of flexion 90 ° and hyperextension ACL were found under PX electronic system. The distance between two points was measured. Changes in the length of two points in the process. Results The 95% confidence interval for the distance from point i to point T at flexion was (25.43 ± 0.455) mm, the maximum was 29.22 mm and the minimum was 20.29 mm. The distance from point i to point T was 95% The confidence interval was (26.90 ± 0.436) mm, the maximum was 29.76 mm, and the minimum was 23.10 mm. The 95% confidence interval for the difference between the two points over the extension and the flexion was (1.47 ± 0.204) mm With a maximum of 3.33 mm and a minimum of 0.47 mm. Conclusions The preoperative X-ray and intraoperative arthroscopy combined with X-ray double monitoring can accurately locate the ischromatic and tibial offset points of ACL according to different individual differences, which can meet the requirement of physiological equidistant reconstruction , While the equipment is not demanding, can be carried out in most hospitals.