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解剖学和非解剖学前交叉韧带后外侧束增强会影响移植物功能。

Anatomic and non-anatomic anterior cruciate ligament posterolateral bundle augmentation affects graft function.

机构信息

Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 1010 Kaufmann Building, Pittsburgh, PA, 15213, USA.

Department of Orthopedics, Via Hospital Group, Istanbul, Turkey.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 May;26(5):1343-1348. doi: 10.1007/s00167-017-4659-7. Epub 2017 Jul 29.

Abstract

PURPOSE

The purpose of this study is to compare knee laxity and graft function (tissue force) between anatomic and non-anatomic posterolateral (PL) bundle augmentation.

METHODS

Twelve (n = 12) fresh-frozen mature, unpaired porcine knees were tested using a robotic testing system. Four knee states were compared: (a) intact anterior cruciate ligament (ACL), (b) deficient PL and intermediate bundles, (c) anatomic PL augmentation, and (d) non-anatomic PL augmentation. Anterior tibial translation (ATT), internal rotation (IR) and external rotation (ER), and the in situ tissue force were measured under an 89.0-N anterior tibial load and 4.0-N m internal and external tibial torques.

RESULTS

Both anatomic and non-anatomic PL augmentation restored the ER, IR, and ATT of the intact knee at all knee flexion angles (n.s.). Both anatomic and non-anatomic PL augmentation restored the in situ tissue force of the ACL during ER and IR loading and ATT loading at all knee flexion angles except at 60° of knee flexion, where the non-anatomic PL augmentation did not restore the in situ tissue force of the ACL during external rotation loading and the anatomic PL augmentation did not restore the in situ tissue force of the ACL during IR loading. Furthermore, there were no differences in ATT, IR, ER, and in situ tissue force under anterior tibial loading, IR and ER loading between the two reconstruction groups.

CONCLUSION

There were no significant differences between anatomic and non-anatomic PL augmentation using the porcine knee model.

摘要

目的

本研究旨在比较解剖型和非解剖型后外侧(PL)束增强的膝关节松弛度和移植物功能(组织力)。

方法

使用机器人测试系统对 12 个(n=12)新鲜冷冻成熟、未配对的猪膝关节进行测试。比较了 4 种膝关节状态:(a)完整前交叉韧带(ACL);(b)PL 和中间束缺陷;(c)解剖型 PL 增强;(d)非解剖型 PL 增强。在 89.0-N 前胫骨负荷和 4.0-N·m 内、外胫骨扭矩下测量前胫骨平移(ATT)、内旋(IR)和外旋(ER)以及原位组织力。

结果

解剖型和非解剖型 PL 增强均在所有膝关节屈曲角度下恢复了完整膝关节的 ER、IR 和 ATT(无统计学意义)。在所有膝关节屈曲角度下,解剖型和非解剖型 PL 增强均恢复了 ACL 在 ER 和 IR 加载以及 ATT 加载期间的原位组织力,但在膝关节屈曲 60°时除外,此时非解剖型 PL 增强未恢复 ACL 的原位组织力在外部旋转加载期间,解剖型 PL 增强在 IR 加载期间未恢复 ACL 的原位组织力。此外,在前胫骨加载、IR 和 ER 加载下,两个重建组之间的 ATT、IR、ER 和原位组织力没有差异。

结论

在猪膝关节模型中,解剖型和非解剖型 PL 增强之间没有显著差异。

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