前十字靭帯再建手術における移植靭帯固定用骨孔の最適方向決定に関する研究

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In this paper, the optimum directions of bone tunnels at the isometric points on tibia and femur for anterior cruciate ligament reconstruction are determined. The crossed four-bar linkage model is applied for knee kinematics. Then the directions of bone tunnels at the isometric points are mathematically described as the anterior angle in the sagittal plane and the medial angle in the coronal plane. Next the following three variables are considered: ( 1 )the bending angle φ between the center line of the fiber part of the graft and the bone tunnel, ( 2 ) the bending angle φ between the center line and the width direction of the fiber part at the exit of bone tunnel, ( 3 ) the strain ε of the graft. In the actual reconstructive procedure, the directions of bone tunnels are limited by surgical accessibility factors such as the design of the drill guide and the soft tissue around the knee. Hence the optimum directions of bone tunnels are determined to minimize the three variables stated previously for knee flection within the area in which bone tunnels can be made. Next, in order to examine the influence of the assumptions for modelling and the individual differences, an experiment using fresh cadaver knees is carried out. The theoretical bending angle and the experimental bending angle are found to be in good agreement. Therefore, in the actual reconstructive procedure, it should be effective to give the bone tunnels the optimum directions determined in this studdy.
社団法人日本機械学会の論文
1992-12-25

前十字靭帯再建手術における移植靭帯固定用骨孔の最適方向決定に関する研究

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