三入路技术对前交叉韧带重建术骨道、移植物等的影响

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Abstract Objective To explore the influence of arthroscopic anterior cruciate ligament reconstruction double-approach(anterior internal and external approaches of knee joint) and three-approach(anterior superior，anterior inferior and anterior external approaches of knee joint) on bone canal length and graft Angleandguide clinical practice.Methods Patients who underwent arthroscopic anterior cruciate ligament reconstruction in the Department of Sports Medicine of Zhengzhou Orthopaedics Hospital from October 2017 to July 2018 were followed up.There were 9 patients in the conventional double-access group，including 6 males and 3 females.The patientswere(31.33±7.47) years old(range：21~47 years old).There were 5 cases of left knee and 4 cases of right knee.There were 9 patients in the three access group，including 6 males and 3 females.The patients were(24.78±6.61) years old(range：19~37 years old).There were 4 cases of left knee and 5 cases of right knee.The length of femoral bone canal，the length of the tibia bone canal and the angle of the graft were measured after anterior cruciate ligament reconstruction and statistical analysis was performed.Results There was no statistically significant difference in age，left and right side between the three-way group and the two-way group.The operation time of the three-way group was(88.33±22.22)min，and the operation time of the double-entry group was(77.22±34.92)min.There was no significant difference between the two groups(P＞0.05).The length of the femoral bone canal in the three-way group was(35.56±5.24) mm，and the length of the femoral bone canal in the double-entry group was(35.87±6.59) mm.There was no significant difference between the two groups(P＞0.05).The length of the tibia bone canal in the three-way group was(39.25±2.63)mm，and the length of the tibia canal in the double-entry group was(33.36±3.50)mm.The length of the tibia canal in the three-way group was significantly longer than that in the double-entry group(P＜0.05).The graft angle of the three-way group was(150.57±8.16)°，and the graft angle of the two-way group was(153.10±6.49)°.There was no significant difference between the two groups(P＞0.05).Conclusion There are no significant difference in the operation time，the length of the femoral bone canal，and the graft angle between the three-way approach group and the conventional two-way approach group.However，the length of the tibia bone canal in the three-way group is significantly longer than the length of the tibia bone canal in the two-way group.The operation is more convenient，the field of view is clearer，and the residual debris in the joint cavity is less.At the same time，it can be clearly seen under the microscope to reduce the risk of graft fixation failure.Therefore，it is recommended to use a three-way approach in anterior cruciate ligament reconstruction.

Key words： arthroscopy anterior cruciate ligament reconstruction three approaches

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	Li Ming
	Liu Ning *

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Li Ming,Liu Ning *. The Effect of Anterior Cruciate Ligament Reconstruction Under Arthroscopy with Three Approaches on Bone Canal Length and Graft Angle[J]. sygkzz, 2019, 25(8): 700-708.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I8/700

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