为了正常的体验网站,请在浏览器设置里面开启Javascript功能!
首页 > PCL重建、胫骨骨道技术

PCL重建、胫骨骨道技术

2014-02-12 30页 ppt 11MB 16阅读

用户头像

is_381403

暂无简介

举报
PCL重建、胫骨骨道技术nullTibial Tunnel in PCL ReconstructionTibial Tunnel in PCL ReconstructionSung-Jae Kim et al, ISAKOS Newsletter (Current Concepts), 2004 Sung-Jae Kim et al, Arthroscopy, 2004 Sung-Jae Kim et al, CORR, 1999 Sung-Jae Kim et al, Arthroscopy, 1998 Sung-Jae Kim et al, ...
PCL重建、胫骨骨道技术
nullTibial Tunnel in PCL ReconstructionTibial Tunnel in PCL ReconstructionSung-Jae Kim et al, ISAKOS Newsletter (Current Concepts), 2004 Sung-Jae Kim et al, Arthroscopy, 2004 Sung-Jae Kim et al, CORR, 1999 Sung-Jae Kim et al, Arthroscopy, 1998 Sung-Jae Kim et al, Arthroscopy, 1994nullSung-Jae Kim M.D.,Jong-Min Kim M.D. Jun-Dae Kwun M.D.,Kwang-Am Jung M.D., Andri MT Lubis M.D. Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul,Korea IntroductionIntroductionConsiderations in Tibial Tunnel Placement of tibial tunnel Direction of tibial tunnelHistorical Review (I)Historical Review (I)Placement of Tibial Tunnel Grood et al, Am J Sports Med, 1989 Bach et al, Am J Sports Med, 1992 : Variations in tibial tunnel position have less effect on graft behavior than that of the femoral tunnel Sung-Jae Kim et al, Arthroscopy, 1994 1. Reproduce the anterolateral component of PCL in graft tunnel placement 2. Post. flat spot of the tibia 1 cm below articular margin & just lateral to the midline Historical Review (I)Historical Review (I)Placement of Tibial Tunnel Miller et al, Knee Surgery, 1994 Harner et al, Am J Sports Med, 1998 : Reproduce the anterolateral component of PCL in graft tunnel placementHistorical Review (I)Historical Review (I)Placement of Tibial Tunnel Mariani et al. Arthroscopy, 1999 : Proper location of femoral tunnel is more critical & difficult than tibial tunnel Kantaras et al,Arthroscopy, 2002 : medial meniscal root attachment used as anatomical landmark for tibial tunnel Historical Review (II)Historical Review (II)Placement of Tibial Tunnel Markolf et al, J Orthop Res, 2003 : errors in medial-lateral placement of the tibial tunnel → not important effects on biomechanics Historical Review (II)Historical Review (II)Direction of Tibial Tunnel Sung-Jae Kim et al, Arthroscopy, 1994 : Anteromedial tibial tunnel Sung-Jae Kim et al, Arthroscopy, 1998 : Anterolateral tibial tunnel reduces stress concentration & graft failure Ohkoshi et al, Arthroscopy, 2001 : By selecting lateral route, it becomes possible to reduce the killer turnHistorical Review (II)Historical Review (II)Direction of Tibial Tunnel Sung-Jae Kim et al, ISAKOS Newsletter (Current Concepts), 2004 : On biomechanical study, lateral approach is highly promising compared to the other approaches nullArthroscopic Intraarticular Interference Screw Technique of PCL Reconstruction : one-incision technique. IAA, Copenhagen, 1993 JOA, Yokohama, 1995 ESKA, Budapest, 1996 AAOS, San Francisco, 1997 AAOS, New Orleans, 1998 Sung-Jae Kim et al, Arthroscopy, 1994 Sung-Jae Kim et al, CORR, 1999 PCL recon. : one-incision techniquePCL recon. : one-incision techniqueDirection of tibial tunnel : from anteromedial Post. flat spot of the tibia 1 cm below articular margin & just lateral to the midline Reproduce the anterolateral component of PCL in graft tunnel placement PCL recon. : one-incision techniquePCL recon. : one-incision techniqueAnteromedial tibial tunnelPCL recon. : one-incision techniquePCL recon. : one-incision techniquenull A modified endoscopic technique for PCL reconstruction using allograft Sung-Jae Kim et al, Arthroscopy, 1998Modified endoscopic technique for PCL Recon.Modified endoscopic technique for PCL Recon.Tibial tunnel was made through, 1. Anterolat. tibial cortex 2cm lat. to the tibial tuberosity 2. Post. flat spot of the tibia 1 cm below articular margin 3. Just lateral to the midline(S-J Kim, Arthroscopy,1998)Modified endoscopic technique for PCL Recon.Modified endoscopic technique for PCL Recon. • Less stress concentration & graft failure • Inspect tibial tunnel • Short tunnel length • Less additional fixation problem(S-J Kim, Arthroscopy,1998) Advantage of lateral tunnelModified endoscopic technique for PCL Recon.Modified endoscopic technique for PCL Recon.Modified endoscopic technique for PCL Recon.Modified endoscopic technique for PCL Recon.Less divergence of the graft within the tibial tunnel & knee jointMore vertical direction & less acute angle of the graftAnteromedial tunnelAnterolateral tunnelnull PCL tunnel : Biomechanical Comparisons of Three Different Tibia Tunnel Directions in PCL Reconstruction Sung-Jae Kim et al, ISAKOS Newsletter (Curren Concepts),2004 Sung-Jae Kim et al, Arthroscopy, 2005PurposePurposeOne reason of the present dilemma in treating PCL injured patients is the abrasions around Killer Turn To compare three types of transtibial tunnel directions: • medial, central, lateral approach Material & MethodsMaterial & MethodsSix cadavers Pressure-sensitive thin film in replacement PCL graft & killer-turn area of the tibia Trilinear elastic & viscoelastic properties 1.Von Mises stresses : criterion for failure 2.Maximum shear stress 3.Resultant forceMaterial & MethodsMaterial & MethodsResultsResultsThe digitized image from the pressure sensitive filmsThe ratios of the No. of black pixels to the total No. of pixelsMaterial & MethodsMaterial & Methods medial15mm20mmcentralResultsResults Trilinear elastic solutionResultsResultsViscoelastic properties : von Mises stressResultsResultsViscoelastic properties : Max. shear stressResultsResultsViscoelastic properties : Resultant forceConclusionConclusion This qualitative study suggests that the lateral approach technique seems to be more promising than the other techniques. nullThank You for Your Attention
/
本文档为【PCL重建、胫骨骨道技术】,请使用软件OFFICE或WPS软件打开。作品中的文字与图均可以修改和编辑, 图片更改请在作品中右键图片并更换,文字修改请直接点击文字进行修改,也可以新增和删除文档中的内容。
[版权声明] 本站所有资料为用户分享产生,若发现您的权利被侵害,请联系客服邮件isharekefu@iask.cn,我们尽快处理。 本作品所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用。 网站提供的党政主题相关内容(国旗、国徽、党徽..)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。
热门搜索

历史搜索

    清空历史搜索