国人ACL起止点解剖与多纤维束动态生物力学相关性研究

发布时间：2018-03-16 06:31

本文选题：前交叉韧带　切入点：止点　出处：《第三军医大学》2006年博士论文　论文类型：学位论文

【摘要】： 一、研究背景和目的: 前交叉韧带(Anterior Cruciate Ligament, ACL)是人体中最为复杂的结构之一,其损伤的治疗越来越引起人们的重视。但随着近年来对ACL在膝关节运动生物力学中功能研究的进一步深入,人们逐渐认识到,目前ACL临床重建技术已无法满足日益增长的对恢复ACL精妙生物力学功能的要求。只有更加仿真地模拟生理ACL解剖结构和力学特性进行重建,才能够最大程度地重现生理ACL的生物力学功能,最终达到满意的临床效果。多纤维束重建是目前开展较为广泛的研究之一,双束重建已在解剖结构和运动控制功能上更加接近生理。但由于多个纤维束起止点的最佳组合方式和对应纤维束在运动中的张力协调更为复杂,给多纤维束重建带来了较大困难,目前此方面开展的研究尚不足以阐明其关系。本研究拟从ACL起止点的解剖和定位方法入手,采用全新设计的国人交叉韧带张力测试系统对ACL的4纤维束动态应力进行测量研究,进一步了解ACL起止点与其多纤维束动态生物力学之间的相关性,为临床重建ACL提供更详细的解剖和力学数据。二、研究方法: 1.国人膝关节ACL起止点形态和定位的解剖与放射学对比研究 (1)32侧正常国人膝关节解剖数据测量:参照Tiburtius法制作标本后测量ACL股、胫骨侧止点的基本解剖数据(印迹中心、径向偏角、最大长径、最大横径)。 (2)12侧正常国人膝关节标本放射学测量:使用金属标记物定位ACL股、胫骨侧止点,在CR片上将股骨侧骨性标记组成4对,分别为:①股骨干远端解剖轴(A)与平行的双后髁切线(B);②双前髁切线(C)与双后髁切线(B);③Blumensaat’s线(D)和与之平行的双股骨髁远端切线(E);④与股骨干远端解剖轴垂直的双髁远端切线(F)和与股骨干远端解剖轴垂直的双后髁切线(G)。胫骨侧使用平台内外缘和前后缘作为骨性标记。使用X-Caliper测量ACL止点印迹与以上骨性标记的距离,计算其在各组骨性标记间距离的比值。
[Abstract]:I. background and purpose of the study:. Anterior cruciate ligament (ACL) is one of the most complex structures in human body, and the treatment of ACL injury has attracted more and more attention. However, with the further research on the function of ACL in knee motion biomechanics in recent years, People have come to realize that at present, the clinical reconstruction technology of ACL can not meet the increasing requirement of restoring the delicate biomechanical function of ACL. Only by simulating the anatomical structure and mechanical properties of physiological ACL more simulatively, In order to reproduce the biomechanical function of physiological ACL to the maximum extent, the satisfactory clinical effect can be achieved. Multi-fiber bundle reconstruction is one of the most extensive researches. The double bundle reconstruction has been more close to physiology in anatomical structure and motion control function. However, the optimal combination of the starting and ending points of multiple fiber bundles and the coordination of the tension of the corresponding fiber bundles in motion are more complicated. It has brought great difficulties to the reconstruction of multi-fiber bundles, but the current research in this field is not enough to clarify its relationship. This study will begin with the anatomical and localization methods of the starting and ending points of ACL. A new Chinese cruciate ligament tension testing system was used to measure the dynamic stress of 4 fiber bundles of ACL. The correlation between the starting and ending points of ACL and the dynamic biomechanics of ACL was further understood. Provide more detailed anatomical and mechanical data for clinical reconstruction of ACL. Second, research methods:. 1. Comparative anatomical and radiologic study on the morphology and location of the starting and ending point of ACL in Chinese knee joint. Measurement of anatomical data of the knee joint of 32 normal Chinese: the basic anatomical data of ACL strands and tibia were measured with reference to the Tiburtius method (imprinted center, radial deviation angle, maximum length diameter, maximum transverse diameter). Radiometric measurement of 12 normal Chinese knee joint specimens: using metal markers to locate the ACL strands and tibia lateral insertion points, 4 pairs of femur bone markers were made up of CR films. The anatomic axis of the distal femoral shaft (A1) and the parallel double posterior condylar tangent (BJ) and the double posterior condylar tangent (C) and the double posterior condylar triangulation (BJ 3 Blumensaatos) and the parallel double femur condylar distal condyle (Ef4) perpendicular to the distal double condyle of the distal femoral shaft. The tibial side was marked by the external and outer margins of the platform and the anterior and posterior edges of the platform. X-Caliper was used to measure the distance between the ACL insertion and the above bone markers. The ratio of the distance between the bone markers in each group was calculated.
【学位授予单位】：第三军医大学
【学位级别】：博士
【学位授予年份】：2006
【分类号】：R322;R318.01

【引证文献】