电磁导航系统辅助后交叉韧带重建胫骨隧道定位的效果评价

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摘要目的评价电磁导航系统辅助后交叉韧带重建胫骨隧道定位的效果，为临床提供更优手术方式。方法选取新鲜冰冻成人下肢膝关节标本30例，不计性别、年龄及左右侧，将标本CT数据导入电磁导航系统行三维建模，术前完成最优手术路径规划，术中于电磁导航系统实时监测下完成胫骨隧道重建，并测量胫骨隧道矢状角度、隧道长度与出口位置。结果 30例膝关节中，28例钢针出针点位于术前规划好的足印区内，为有效的胫骨隧道，电磁导航辅助下胫骨隧道定位的有效率为93.33%，有效例数中优良率为85.71%(24/28)。术前规划矢状角度为(59.72±2.32)°，术后实测为(59.55±2.35)°，误差为(0.16±1.9)°；术前规划胫骨隧道长度为(69.56±2.79)mm，术后实测为(70.34±2.38)mm，误差为(－0.78±2.27)mm。术前规划胫骨虚拟隧道矢状角度、长度与术后实测比较差异均无统计学意义(P＞0.05)。结论电磁导航系统辅助下行后交叉韧带重建中胫骨隧道定位，精准度高，操作方便，可以作为一种良好的辅助定位方式。

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关键词 ：电磁导航, 后交叉韧带重建, 胫骨隧道, 关节镜, 矢状角度

Abstract：Objective To evaluate the effect of the electromagnetic navigation system in assisting the posterior cruciate ligament reconstruction of the tibial tunnel positioning，and to provide a better surgical method for the clinic.Methods 30 fresh frozen adult knee joint specimens of the lower limbs were selected，regardless of gender，age，and left and right sides.The CT data of the specimens were imported into the electromagnetic navigation system for three-dimensional modeling.The optimal surgical path planning was completed before the operation，and the electromagnetic navigation system was real-time during the operation.The reconstruction of the tibial tunnel was completed under monitoring，and the sagittal angle，tunnel length and exit position of the tibial tunnel were measured.Results Among 30 cases of knee joints，28 cases of steel needle exit point were located in the preoperatively planned footprint area，which was an effective tibial tunnel.The effective rate of electromagnetic navigation assisted tibial tunnel positioning was 93.33%.The excellent and good rate was 85.71% (24/28).The preoperative planning sagittal angle is (59.72±2.32)°，the postoperative measurement is (59.55±2.35)°，the error is (0.16±1.9)°；the preoperative planning tibial tunnel length is (69.56±2.79)mm，and the postoperative The actual measurement is (70.34±2.38)mm，and the error is (－0.78±2.27)mm.There was no significant difference in the sagittal angle and length of the tibial virtual tunnel planned before operation and the actual measurement after operation (P＞0.05).Conclusion The electromagnetic navigation system assists in the positioning of the tibial tunnel in the downward reconstruction of the posterior cruciate ligament，with high accuracy and convenient operation，which can be used as a good auxiliary positioning method.

Key words： electromagnetic navigation technology posterior cruciate ligament reconstruction tibial tunnel arthroscopy sagittal angle

基金资助:泰山学者工程专项经费资助项目(ts201511110)

通讯作者: 丛海波

作者简介: 胡鹏宇(1993－ )，男，研究生在读，青岛大学附属威海市中心医院运动医学科，264400。

引用本文:

胡鹏宇，余志平，刘端正，贾国庆，张海清，丛海波 *. 电磁导航系统辅助后交叉韧带重建胫骨隧道定位的效果评价[J]. 实用骨科杂志, 2020, 26(8): 703-706.
Hu Pengyu，Yu Zhiping，Liu Duanzheng，et al. Evaluation of the Effect of Electromagnetic Navigation System assisted Posterior Cruciate Ligament Reconstruction on Tibial Tunnel Positioning. sygkzz, 2020, 26(8): 703-706.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I8/703

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