前交叉韧带重建术中的髌骨骨折：体外分析
PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS.
作者信息
Ferrer Marcelo DE Almeida, Lobo Mariana DE Oliveira, Almeida Laís Maria Pinto, Freitas Anderson, Macedo Neto Sílvio Leite DE, Paiva Leonardo Morais, Battaglion Leonardo Rigobello
机构信息
Clínica OrtoSul, Brasília, DF, Brazil.
Hospital Regional do Gama, Serviço de Residência Médica em Ortopedia e Traumatologia, Brasília, DF, Brazil.
出版信息
Acta Ortop Bras. 2023 May 1;31(2):e259557. doi: 10.1590/1413-785220233102e259557. eCollection 2023.
OBJECTIVE
To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.
METHODS
From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).
RESULTS
The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.
CONCLUSION
In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used.
目的
通过生物力学分析确定前交叉韧带（ACL）重建中安全的髌骨截骨界限，以将骨折风险降至最低。
方法
从三维重建开始，在髌骨上进行三角形截骨，深度为6.5毫米，宽度和长度可变（分别为10至20毫米和8至12毫米，两者间隔均为1毫米）。这些截骨组合构成55个测试模型，宽度有5种变化，长度有11种变化，采用有限元方法（FEM）进行测试。
结果
局部主最大值（拉力）的平均值为4.36帕（标准差0.87±0.76），局部主最小值（压力）为-4.33帕（标准差1.05±1.11）。将宽度和长度与主最大值的拉力值进行比较，我们发现宽度从11毫米起、长度从13毫米起具有统计学意义。
结论
在ACL重建中，对于宽度小于11毫米且长度小于13毫米的髌骨骨块切除是安全的，这分别相当于所用髌骨宽度的24%和长度的28%。
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