前交叉韧带与Ramp损伤修复的生物力学对比
Orthopedic Journal of China(2022)
Abstract
[目的]比较前交叉韧带与Ramp损伤不同修复的运动学改变.[方法]16个新鲜尸体膝,均依次进行以下模型建立与运动学测试,处理顺序为:正常对照(normal control,NC),ACL切断+Ramp损伤组(ACL cutting and Ramp injury,ACRI)、ACL重建+Ramp损伤组(ACL reconstruction and Ramp injury,ARRI).将16个膝分为两组,每组8膝,分别为ACL重建+Ramp缝合钩修复组(ACL reconstruction and suture hock repair for Ramp injury,ARSH)和 ACL 重建+Ramp Fast-fix 修复组(ACL recon-struction and fast-fix repair for Ramp injury,ARFF).将标本固定于力学测试仪,于屈曲0°、30°、60°、90°,施加前向134N恒定载荷,和内外旋5N·m载荷,测量胫骨前移距离、内旋和外旋角度.[结果]各屈膝角度状态下,胫骨前移、内旋和外旋由低至高总体依次为,NC<ARSH<ARFF<ARRI<ACRI,总体差异均有统计学意义(P<0.05).在各屈膝角度下,ARSH组与ARFF组胫骨前移距离的差异均无统计学意义(P>0.05).在屈膝0°、30.和60.下ARSH组胫骨内旋均显著小于ARFF组(P<0.05),但在屈膝90.下ARSH组与ARFF胫骨内旋的差异无统计学意义(P>0.05).在各屈膝角度下ARSH组与ARFF胫骨外旋的差异均无统计学意义(P>0.05).[结论]在膝关节ACL合并Ramp损伤ACL重建中,缝合钩与Fast-fix缝合修复Ramp损伤均能提高膝关节的稳定性,但与Fast-fix缝合修复相比,缝合钩修复能更好地恢复膝关节内旋稳定性.
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