目的 探讨前交叉韧带重建术中经胫骨技术是否可以获得股骨隧道的解剖定位.方法 2007年6月-2010年2月行自体半腱肌腱和股薄肌腱单束重建前交叉韧带手术患者198例,均采用关节镜下修复,术后通过膝关节正侧位X线片回顾性评价了骨隧道位置.其中188例获得随访,随访时间24-36个月,平均:27个月.患者在术后12、24个月进行了前抽屉试验及Lachman试验、Lysholm评分,检查膝关节稳定性以及关节功能.以Spearman相关分析进行统计.结果 术后膝关节稳定以及Lysholm评分优良的(83-100分)为171例(91％).在171例中进行膝关节X线片测评,侧位股骨骨道位于Blumensaat's线的79％(SD4),胫骨骨道位于胫骨平台的41％(SD6),在正位胫骨骨道与关节线向内呈25°(SD3).骨隧道位置与Lysholm评分有相关性(P＜0.01).结论 标准化手术操作和解剖标志可使经胫骨技术的ACL重建建立良好的骨道位置.%Objective To study whether transtibial technique in anterior cruciate ligament(ACL) reconstruction can locate the anatomical femoral tunnel. Methods A total of 198 patients underwent arthroscopic single-bundle ACL reconstruction with autogenous scmitendinosus tendon and gracilis tendon from June 2007 to February 2010. The position of femoral tunnel was retrospectively evaluated by plain radiography. Of the 198 patients, 188 were followed up for an average period of 27 months(range 24-36 months)- The stability and function of knee were evaluated by anterior drawer test, Lachman test and Lychohu scores 12 and 24 months after ACL reconstruction. Spearman correlation analysis was performed. Results Of the 198 patients, 171(90%) had an excellent knee stability and a high Lysholm score(83-100). Radiography showed that femoral tunnel was located in 79%(SD4) of blumensaat' s line and tibial tunnel was located in 41 %(SD6) of tibial plateau. The mean inclination of tibial tunnel in the coronal plane was 250(SD3). The position of bone tunnel was correlated with the Lysholm score. Conclusion Standard surgical technique and anatomical landmarks can achieve optimal tunnel positioning using the transtibial technique for ACL reconstruction.
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