认真研学了美国关节镜专家Brian J. cole和Jon K. Sekiya 关节镜名著<<Surgical Techniques of the Shoulder, Elbow, and Knee in Sports Medicine(肩、肘、膝运动医学手术技巧)之第62章<<CHAPTER 62 – Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction(自体腘绳肌肌腱移植重建膝关节前交叉韧带)。受益匪浅。为今后更好地为膝关节前交叉韧带损伤的患者提供更好的手术技术服务打下了良好的基础。 References参考文献 1. Aglietti P, Giron F, Buzzi R, et al: Anterior cruciate ligament reconstruction: bone–patellar tendon–bone compared with double semitendinosus and gracilis tendon grafts. 膝关节前交叉韧带重建:骨髌腱骨移植物和半腱肌、骨薄肌肌腱移植物的比较 J Bone Joint Surg Am 2004; 86:2143-2155. 2. Aune AK, Holm I, Risberg MA, et al: Four-strand hamstring tendon autograft compared with patellar tendon–bone autograft for anterior cruciate ligament reconstruction: a randomized study with two-year followup. 膝关节前交叉韧带损伤重建:4股自体腘绳肌肌腱移植物和骨髌腱骨移植物的一项随机研究的两年随访Am J Sports Med 2001; 29:722-728. 3. Bernard M, Hertel P, Hornung H, Cierpinski T: Femoral insertion of the ACL. Radiographic quadrant method.膝关节前交叉韧带股骨止点的放射学四边框法定位jiancja Am J Knee Surg 1997; 10:14-22 . 4. Brand JC, Weiler A, Caborn DNM, et al: Graft fixation in cruciate ligament reconstruction.交叉韧带重建的移植物固定 Am J Sports Med 2000; 28:761-774. 5. Brown CH, Steiner ME, Carson EW: The use of hamstring tendons for anterior cruciate ligament reconstruction. Technique and results. 使用腘绳肌重建前交叉韧带:技术和结果 Clin Sports Med 1992; 12:723-756. 6. Brown CH, Wilson DR, Hecker AT, Ferragamo M: Graft-bone motion and tensile properties of hamstring and patellar tendon anterior cruciate ligament femoral graft fixation under cyclic loading. 循环载荷下腘绳肌肌腱和髌腱重建前交叉韧带股骨侧固定移植物骨活动和张力特点 Arthroscopy 2004; 20:922-935. 7. Brown CH, Sklar JH, Darwich N: Endoscopic anterior cruciate ligament reconstruction using autogenous doubled gracilis and semitendinosus tendons. Tech Knee Surg 2004; 3:215-237. 8. Brucker PU, Zelle BA, Fu F: Intraarticular endobutton displacement in anatomic anterior cruciate ligament double-bundle reconstruction: a case report. Oper Tech Orthop 2005; 15:154-157. 9. Carofino B, Fulkerson J: Medial hamstring tendon regeneration following harvest for anterior cruciate reconstruction: fact, myth, and clinical implication. Arthroscopy 2005; 21:1257-1264. 10. Cohen SB, Fu F: Three-portal technique for anterior cruciate ligament reconstruction: use of a central medial portal. Arthroscopy 2007; 23:325.e1-325.e5. 11. Cooley VJ, Deffner KT, Rosenberg TD: Quadrupled semitendinosus anterior cruciate ligament reconstruction: 5-year results in patients without meniscus loss. Arthroscopy 2001; 17:795-800. 12. Eriksson K, Anderberg P, Hamberg P, et al: There are differences in early morbidity after ACL reconstruction when comparing patellar tendon and semitendinosus tendon graft. A prospective randomized study of 107 patients. Scand J Med Sci Sports 2001; 11:170-177. 13. Feller JA, Webster KE: A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 2003; 31:564-573. 14. Freedman K, D'Amato M, Nedeff D, et al: Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autograft. Am J Sports Med 2003; 31:2-11. 15. Gobbi A, Mahajan S, Zanazzo M, Tuy B: Patellar tendon versus quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a prospective clinical investigation in athletes. Arthroscopy 2003; 19:592-601. 16. Hamner DL, Brown CH, Steiner ME, et al: Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg Am 1999; 81:549-557. 17. Harilainen A, Sandelin J, Jansson K: Cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction with hamstring tendons: results of a controlled prospective randomized study with 2 year followup. Arthroscopy 2005; 21:25-33. 18. Kartus J, Movin T, Karlsson J: Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy 2001; 17:971-980. 19. Kousa P, Järvinen TLN, Vihavainen M, et al: The fixation strength of six hamstring tendon graft fixation devices in anterior cruciate ligament reconstruction. Part I: femoral site. Am J Sports Med 2003; 31:174-181. 20. Kousa P, Järvinen TLN, Vihavainen M, et al: The fixation strength of six hamstring tendon graft fixation devices in anterior cruciate ligament reconstruction. Part II: tibial site. Am J Sports Med 2003; 31:182-188. 21. Levy M, Prud'homme J: Anatomic variations of the pes anserinus: a cadaver study. Orthopedics 1993; 16:601-606. 22. Liden M, Ejerhed L, Sernert N, et al: Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with 7-year followup. Am J Sports Med 2007; 35:740-748. 23. Loh JC, Fukuda Y, Tsuda E, et al: Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o'clock and 10 o'clock femoral tunnel positions. Arthroscopy 2003; 19:297-304. 24. Magen HE, Howell SM, Hull ML: Structural properties of six tibial fixation methods for anterior cruciate ligament soft tissue grafts. Am J Sports Med 1999; 27:35-43. 25. O'Donnell JB, Scerpella TA: Endoscopic anterior cruciate ligament reconstruction: modified technique and radiographic view. Arthroscopy 1995; 11:577-584. 26. Pinczewski LA, Lyman J, Salmon LJ, et al: A 10-year comparison of anterior reconstruction with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 2007; 35:564-574. 27. Prodromos CC, Han YS, Keller BL, Bolyard RJ: Stability results of hamstring anterior cruciate ligament reconstruction at 2- to 8-year followup. Arthroscopy 2005; 21:138-146. 28. Prodromos CC, Joyce BT, Shi K, Keller BL: A metaanalysis of stability after anterior cruciate ligament reconstruction as a function of hamstring versus patellar tendon graft and fixation type. Arthroscopy 2005; 21:1202-1208. 29. Radowski CA, Harner CD: Medial portal technique for anterior cruciate ligament reconstruction. In: El Attrache NS, Harner CD, Mirzayan R, Sekiya JK, ed. Surgical Technique in Sports Medicine, Philadelphia: Lippincott Williams Wilkins; 2007:359-367. 30. Shaieb MD, Kan DM, Chang SK, et al: A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 2002; 30:214-220. 31. Soloman CG, Pagnani MJ: Hamstring tendon harvesting: reviewing anatomic relationships and avoiding pitfalls. Orthop Clin North Am 2003; 34:1-8. 32. Tashiro T, Kurosawa H, Kawakami A, et al: Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single- and double-tendon harvest. Am J Sports Med 2003; 31:522-529. 33. Yunes M, Richmond JC, Engels EA, Pinczewski LA: Patellar versus hamstring tendons in anterior cruciate ligament reconstruction: a metaanalysis. Arthroscopy 2001; 17:248-257. 待补。
比利时的影像解剖学专家Michel De Maeseneer等在2004年4月的AJR Am J Roentgenol(美国放射学杂志)上撰文,分析了膝关节后关节囊区域的正常解剖与病理。 文中称:膝关节内侧和膝关节外侧的解剖结构的影像学特点都已有专家进行报道。膝关节后内侧和膝关节后外侧角的解剖和病理也已经有了很多相关报道。但是,还没见到过文章专门探讨膝关节腘窝水平后关节囊区域的解剖特点。这个区域在核磁共振的矢状位上可以看的比较清晰。发源于膝关节后内侧和后外侧的纤维组成了膝关节后关节囊。从膝关节的后内侧,半膜肌肌腱的远端一部分越过膝关节的后侧。这个部分又叫做腘斜韧带。从膝关节的后外侧,源于弓形韧带的纤维组成了膝关节后关节囊。一些疾病常常会影响膝关节后关节囊或髁间区域。为了精确地确定后关节囊区域病变的准确定位,我们要膝关节后关节囊区域的正常解剖。对膝关节后关节囊病变的准确定位对确定手术入路和进行鉴别诊断具有重要意义。该文中,作者通过三具尸体的膝关节核磁共振研究和解剖学研究,为大家呈现了膝关节后关节囊的解剖特点。并从骨关节影像图库里面选出了膝关节后关节囊区域的病例。这三具冰冻尸体来源于已故的三位老年人(去世时分别为65岁,71岁,80岁)。尸体解冻后,用核磁共振分别进行冠状位、横截面和矢状位的扫描。用Hodler等人的方法,按照核磁共振解剖,用带锯做成切片。 该文主要包括以下几个部分:1、后关节囊区域的正常解剖。2、后关节囊的创伤性损伤。3、后关节囊肿胀。4、后关节囊囊肿性病变。5、后关节囊滑囊病变。6、后关节囊肿瘤和假性肿瘤等等。 参考链接: 1、全文链接: http://www.ajronline.org/content/182/4/955.long 2、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed?term=Normal%20Anatomy%20and%20Pathology%20of%20the%20Posterior%20Capsular%20Area%20of%20the%20Knee AJR Am J Roentgenol. 2004 Apr;182(4):955-62. Normal anatomy and pathology of the posterior capsular area of the knee : findings in cadaveric specimens and in patients. De Maeseneer M , Van Roy P , Shahabpour M , Gosselin R , De Ridder F , Osteaux M . Source Department of Experimental Anatomy , Vrije Universiteit Brussel, Jette, Belgium 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!