MRI影像下股骨髁间窝的三维可视化研究
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摘要
第一部分、MRI影像下股骨髁间窝三维数字化解剖与实体解剖测量值的对比研究
[目的]
随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型,可为髁间窝的解剖学研究提供新的路径。故本研究基于MRI影像下建立尸体股骨髁间窝三维数字化模型测量其解剖数据,并与尸体股骨髁间窝实体解剖数据比较,探讨基于MRI影像下重建股骨髁间窝三维数字化模型的准确性及可靠性。
[方法]
1、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行MR扫描获取二维图像。把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建,分别测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为三维重建组。
2、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行实体解剖,分别测量实体股骨髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为实体组。
3、运用SPSS Statistics17.0统计学软件进行分析,两组数据及比值均数比较采用配对样本t检验,以α=0.05作为检验标准。
[结果]
1、男性三维重建组和实体组的ECW, ICH. BLL、LCW、MCW、 SLLC、SLMC、ALC、AMC比较均无差异(p>0.05)、髁间窝指数无差异(p>0.05)。
2、女性三维重建组和实体组的ICW、ECW、ICH、BLL、LCW、MCW、 SLLC、SLMC、ALC. AMC比较均无差异(p>0.05)、髁间窝指数无差异(p>0.05)。
[结论]
基于MRI影像下股骨髁间窝的三维数字化模型能够准确反映实体标本解剖信息,可用于正常人股骨髁间窝的解剖学研究,并对髁间窝相关疾病诊治、交叉韧带重建术具有重要的指导意义。
第二部分、基于MRI影像下股骨髁间窝的数字化解剖学研究
[目的]
随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型并对其进行解剖学研究成为重要的研究方法之一,为髁间窝的解剖学研究提供了新的路径。通过基于健康成人膝关节MR二维影像对股骨髁间窝的三维重建,研究股骨髁间窝的解剖形态,以及对比其在性别方面和同体左右侧的差别,探讨虚拟化髁间窝成形术的临床运用价值。
[方法]
1、对15例男性、15例女性健康受试者双膝关节进行MR扫描获取二维图像,把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建获得三维数字化模型,测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW),计算髁间窝宽度指数(NWI)及髁间窝形态指数(NSI)。
2、运用Mimics软件对患者股骨髁间窝三维数字化模型进行虚拟化髁间窝成形术。
3、通过术中、术后评估髁间窝成形术后髁间窝和交叉韧带的解剖关系。
4、运用SPSS17.0统计学软件进行分析,男女股骨髁间窝数字化模型测量各项数据均数比较采用独立样本t检验,同体左右股骨髁间窝数字化模型测量各项数据均数比较采用配对样本t检验,以α=0.05作为检验标准。
[结果]
1、男性与女性股骨髁间窝的三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW皆具有显著性差异(P<0.05),NWI和NSI无显著性差异(P>0.05)。
2、男性及女性左右股骨髁间窝三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW、NWI、NSI均无显著性差异(P>0.05)。
3、ACL重建术中参照术前虚拟切除骨量进行髁间窝成形,术中观察重建韧带在膝关节过伸位上刚好接近髁间窝顶壁及侧壁,术后3月重建膝关节三维数字化模型发现重建的交叉韧带与髁间窝无撞击。
[结论]
男性与女性髁间窝解剖形态显著性差异,NWI及NSI无差异；同体左右股骨髁间窝各测量指标无显著性差异；髁间窝指数是反映髁间窝狭窄程度的指标之一,有利于指导髁间窝成形术；虚拟髁间窝成形术具有可行性,它可为前交叉韧带重建术中髁间窝成形提供术前参考,具有一定的临床指导意义。
Part1. The anatomy research on3-D digital anatomic model based on MR images of intercondylar notch compared with entity anatomy measured data
Objective
With the development of Computer Assisted Technique and digital anatomy, to establish the digital anatomic model of intercondylar notch could find a new path for anatomic study on intercondylar notch. To explore the accuracy and feasibility of3-D digital model of femoral intercondylar notch based on MR images through comparing the differences of anatomic data between3-D digital model and cadaver.
Methods
1. To scan and get2-D MR images from18male fresh frozen cadaveric knees and14female fresh cadaveric knees. The MR images were imported into Mimics Software for3-D intercondylar notch reconstruction, and the related anatomical data which were gotten from the3-D digital model named as3-D reconstruction group and the data of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC were measured.
2. The cadaveric of18male and14female knees were dissected and measured the anatomic data which were named as entity group and the data of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC were measured.
3. To analyze the data of the two groups by paired-samples t test of SPSS17.0statistical software, with a=0.05as a standard deviation.
Results
1. The measured values of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC in male had no differences between the3-D reconstruction group and entity group (P>0.05).
2. The measured values of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC in female had no differences between the3-D reconstruction group and entity group (P>0.05).
Conclusion
The3-D digital model based on MR images could accurately show the entity specimens information. It could be used for anatomic research of the normal femoral intercondylar notch. It was important for diagnosis and treatment on the related diseases of intercondylar notch and ACL reconstruction.
Part2. The digital anatomic research on3-D digital intercondylar notch model based on MR images
Objective
With the development of Computer Assisted Technique and digital anatomy, the digital anatomic model of intercondylar notch had been used for anatomic study. It had been provided a new path for anatomic study on intercondylar notch. To establish3-D intercondylar notch of the healthy adult knee based on2-D MR Images, and the index of anatomy and its difference between sex, left and right knees. To study the feasibility of virtual intercondylar notchplasty before the ACL reconstruction.
Methods
1. There were15male and15female bilateral knees of healthy adult scanned by2-D MR images. The MR images were imported into Mimics Software for3-D intercondylar notch reconstruction, and the related anatomic data of the3-D digital model were gotten.
2. The intercondylar notchplasty was simulated with3-D intercondylar notch model in Mimics software.
3. The anatomic relationship between intercondylar notch and ACL was evaluated during operation and after operation.
4. To analyze the data of the two groups of male and female by independent sample t test and two groups of left and right knee by paired-samples t test of SPSS17.0statistical software, with a=0.05as a standard deviation.
Results
1. The values of ICW, ECW, ICH, BLL, LCW, MCW in3-D digital knee model had significant difference between male and female(p<0.05), But no difference in the NWI between male and female(p>0.05).
2. There was no significant difference between the left and right on ICW, ECW, ICH, BLL, LCW, MCW, NWI, NSI in3-D digital knee model of male and female (p>0.05).
3. Intercondylar notchplasty was done by preoperative simulated plan with3-D digital model, and it was just fit for the intercondylar notch top and side wall, and the postoperative3-D digital model reconstruction of the ACL and intercondylar notch wall had no impingement.
Conclusion
The anatomy of intercondylar notch was significant difference between male and female, but it had no difference in NWI and NSI, and the data of intercondylar notch had no difference in left and right. NWI was one of indexes which showed the narrow level of intercondylar notch. The virtual intercondylar notchplasty was feasible, and it could provide preoperative plan for intercondylar notchplasty in ACL reconstruction, and it showed important clinical instructing significance.
[目的]
随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型,可为髁间窝的解剖学研究提供新的路径。故本研究基于MRI影像下建立尸体股骨髁间窝三维数字化模型测量其解剖数据,并与尸体股骨髁间窝实体解剖数据比较,探讨基于MRI影像下重建股骨髁间窝三维数字化模型的准确性及可靠性。
[方法]
1、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行MR扫描获取二维图像。把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建,分别测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为三维重建组。
2、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行实体解剖,分别测量实体股骨髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为实体组。
3、运用SPSS Statistics17.0统计学软件进行分析,两组数据及比值均数比较采用配对样本t检验,以α=0.05作为检验标准。
[结果]
1、男性三维重建组和实体组的ECW, ICH. BLL、LCW、MCW、 SLLC、SLMC、ALC、AMC比较均无差异(p>0.05)、髁间窝指数无差异(p>0.05)。
2、女性三维重建组和实体组的ICW、ECW、ICH、BLL、LCW、MCW、 SLLC、SLMC、ALC. AMC比较均无差异(p>0.05)、髁间窝指数无差异(p>0.05)。
[结论]
基于MRI影像下股骨髁间窝的三维数字化模型能够准确反映实体标本解剖信息,可用于正常人股骨髁间窝的解剖学研究,并对髁间窝相关疾病诊治、交叉韧带重建术具有重要的指导意义。
第二部分、基于MRI影像下股骨髁间窝的数字化解剖学研究
[目的]
随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型并对其进行解剖学研究成为重要的研究方法之一,为髁间窝的解剖学研究提供了新的路径。通过基于健康成人膝关节MR二维影像对股骨髁间窝的三维重建,研究股骨髁间窝的解剖形态,以及对比其在性别方面和同体左右侧的差别,探讨虚拟化髁间窝成形术的临床运用价值。
[方法]
1、对15例男性、15例女性健康受试者双膝关节进行MR扫描获取二维图像,把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建获得三维数字化模型,测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW),计算髁间窝宽度指数(NWI)及髁间窝形态指数(NSI)。
2、运用Mimics软件对患者股骨髁间窝三维数字化模型进行虚拟化髁间窝成形术。
3、通过术中、术后评估髁间窝成形术后髁间窝和交叉韧带的解剖关系。
4、运用SPSS17.0统计学软件进行分析,男女股骨髁间窝数字化模型测量各项数据均数比较采用独立样本t检验,同体左右股骨髁间窝数字化模型测量各项数据均数比较采用配对样本t检验,以α=0.05作为检验标准。
[结果]
1、男性与女性股骨髁间窝的三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW皆具有显著性差异(P<0.05),NWI和NSI无显著性差异(P>0.05)。
2、男性及女性左右股骨髁间窝三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW、NWI、NSI均无显著性差异(P>0.05)。
3、ACL重建术中参照术前虚拟切除骨量进行髁间窝成形,术中观察重建韧带在膝关节过伸位上刚好接近髁间窝顶壁及侧壁,术后3月重建膝关节三维数字化模型发现重建的交叉韧带与髁间窝无撞击。
[结论]
男性与女性髁间窝解剖形态显著性差异,NWI及NSI无差异；同体左右股骨髁间窝各测量指标无显著性差异；髁间窝指数是反映髁间窝狭窄程度的指标之一,有利于指导髁间窝成形术；虚拟髁间窝成形术具有可行性,它可为前交叉韧带重建术中髁间窝成形提供术前参考,具有一定的临床指导意义。
Part1. The anatomy research on3-D digital anatomic model based on MR images of intercondylar notch compared with entity anatomy measured data
Objective
With the development of Computer Assisted Technique and digital anatomy, to establish the digital anatomic model of intercondylar notch could find a new path for anatomic study on intercondylar notch. To explore the accuracy and feasibility of3-D digital model of femoral intercondylar notch based on MR images through comparing the differences of anatomic data between3-D digital model and cadaver.
Methods
1. To scan and get2-D MR images from18male fresh frozen cadaveric knees and14female fresh cadaveric knees. The MR images were imported into Mimics Software for3-D intercondylar notch reconstruction, and the related anatomical data which were gotten from the3-D digital model named as3-D reconstruction group and the data of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC were measured.
2. The cadaveric of18male and14female knees were dissected and measured the anatomic data which were named as entity group and the data of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC were measured.
3. To analyze the data of the two groups by paired-samples t test of SPSS17.0statistical software, with a=0.05as a standard deviation.
Results
1. The measured values of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC in male had no differences between the3-D reconstruction group and entity group (P>0.05).
2. The measured values of ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC, AMC in female had no differences between the3-D reconstruction group and entity group (P>0.05).
Conclusion
The3-D digital model based on MR images could accurately show the entity specimens information. It could be used for anatomic research of the normal femoral intercondylar notch. It was important for diagnosis and treatment on the related diseases of intercondylar notch and ACL reconstruction.
Part2. The digital anatomic research on3-D digital intercondylar notch model based on MR images
Objective
With the development of Computer Assisted Technique and digital anatomy, the digital anatomic model of intercondylar notch had been used for anatomic study. It had been provided a new path for anatomic study on intercondylar notch. To establish3-D intercondylar notch of the healthy adult knee based on2-D MR Images, and the index of anatomy and its difference between sex, left and right knees. To study the feasibility of virtual intercondylar notchplasty before the ACL reconstruction.
Methods
1. There were15male and15female bilateral knees of healthy adult scanned by2-D MR images. The MR images were imported into Mimics Software for3-D intercondylar notch reconstruction, and the related anatomic data of the3-D digital model were gotten.
2. The intercondylar notchplasty was simulated with3-D intercondylar notch model in Mimics software.
3. The anatomic relationship between intercondylar notch and ACL was evaluated during operation and after operation.
4. To analyze the data of the two groups of male and female by independent sample t test and two groups of left and right knee by paired-samples t test of SPSS17.0statistical software, with a=0.05as a standard deviation.
Results
1. The values of ICW, ECW, ICH, BLL, LCW, MCW in3-D digital knee model had significant difference between male and female(p<0.05), But no difference in the NWI between male and female(p>0.05).
2. There was no significant difference between the left and right on ICW, ECW, ICH, BLL, LCW, MCW, NWI, NSI in3-D digital knee model of male and female (p>0.05).
3. Intercondylar notchplasty was done by preoperative simulated plan with3-D digital model, and it was just fit for the intercondylar notch top and side wall, and the postoperative3-D digital model reconstruction of the ACL and intercondylar notch wall had no impingement.
Conclusion
The anatomy of intercondylar notch was significant difference between male and female, but it had no difference in NWI and NSI, and the data of intercondylar notch had no difference in left and right. NWI was one of indexes which showed the narrow level of intercondylar notch. The virtual intercondylar notchplasty was feasible, and it could provide preoperative plan for intercondylar notchplasty in ACL reconstruction, and it showed important clinical instructing significance.
引文
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[19]Shelbourne KD, Kerr B. The relationship of femoral intercondylar notch width to height, weight, and sex in patients with intact anterior cruciate ligaments [J]. Am J Knee Surg.2001; 14(2):92-96.
[20]Charlton WPH, John TAS, Ciccotti MG,et al. Differences in Femoral Notch Anatomy between Men and Women:A Magnetic Resonance Imaging Study[J]. Am J Sports Med, 2002;30(3):329-333.
[21]Anderson AF,LipscombAB,Liudahl KJ,et al. Analysis of the intercondylar notch by computed tomography[J]. Am J Sports Med.1987; 15(6):547-552.
[22]Souryal TO, Moore HA,Evans JP. Bilaterality in anterior cruciate ligament injuries Associated intercondylar notch stenosis[J]. Am J Sports Med.1988; 16(5);449-454.
[23]袁峰,赵金忠.前交叉韧带重建术.见：赵金忠.膝关节重建外科学[M].河南：河南科学技术出版社,2007,1-13.
[24]Van Dijck RA, Saris DB, Willems JW, et al. Additional Surgery After Anterior Cruciate Ligament Reconstruction:Can We Improve Technical Aspects of the Initial Procedure? [J].Arthroscopy.2008;24(1):88-95.
[25]韩晓鹏,纪斌平.前交叉韧带重建技术的进展[J].国际骨科学杂志.2008,29(3)：173-176.
[26]Farrow LD, Chen MR, Cooperman DR,et al. Morphology of the Femoral Intercondylar Notch[J]. J Bone Joint Surg Am.2007;89(10):2150-2155.
[27]Pape D, Seil R, Adam F, et al. Blood loss in anterior cruciate ligament (ACL) reconstruction with and without intercondylar notchplasty:does it affect the clinical outcome? [J].Arch Orthop Trauma Surg,2001;121(10):574-577.
[28]Shelbourne KD, DavisTJ,Klootwyk TE. The Relationship Between Intercondylar Notch Width of the Femur and the Incidence of Anterior Cruciate Ligament Tears:A Prospective Study[J]. Am J Sports Med,1998; 16(3):402-408.
[29]Shelbourne KD,Benner TR.Intercondylar notch width measurement differences between African American and white men and women with intact anterior cruciate ligament knees[J].Am J Sports Med.2007;35(8):1304-1307.
[30]Dienst M, Schneider G, Altmeyer K, et al.Correlation of intercondylar notch cross sections to the ACL size:a high resolution MR tomographic in vivo analysis[J]. Arch Orthop Trauma Surg.2007;127(4):253-60.
[31]Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction [J]. J Bone Joint Surg Am.1985;67(2):257-62.
[32]Herzog RJ, Silliman JF, Hutton K,et al. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging[J]. Am J Sports Med.1994;22(2):204-10.
[33]Souryal TO, Freemen TR. Intercondylar notch size and anterior cruciate ligament injuries in athletesA prospective study[J]. Am J Sports Med.1993;21(4):535-539.
[34]Tillman MD, Smith KR, Bauer JA, et al.Differences in three intercondylar notch geometry indices between males and females:acadaver study[J].Knee.2002;9(1):41-46.
[35]Teitz CC, Lind BK, Sacks BM. Symmetry of the femoral notch width index [J]. Am J Sports Med.1997;25(5):687-90.
[36]Muneta T, Takakuda K, Yamamoto H.Intercondylar notch width and its relation to the configuration and cross-sectional area of the anterior cruciate ligament. A cadaveric knee study[J].Am J Sports Med.1997;25(1):69-72.
[37]邓军,梁碧玲,陈建宇,等.股骨髁间窝和前交叉韧带断面的3D TSE MRI测量[J].中国骨与关节损伤杂志,2009,24(7)：589-591.
[38]Vergis A, Gillquisr J. Graft failure in intra-articular anterior cruciate ligament reconstructions: A review of the literature [J]. Arthroscopy.1995;11 (3):312-321.
[39]LaPrade RF, Terry GC,Montgomery RD, et al. The effects of aggressive notchplasty on the normal knee indogs[J]. Am J Sports Med.1998;26(2):193-200.
[40]Asahina S, Muneta T, Ezura Y, et al.Notchplasty in anterior cruciate ligament reconstruction: An Experimental Animal Study?Arthroscopy.2000; 16(2):165-172.
[41]Simon RA, Everhart JS, Nagaraja HN, et al. A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees[J], J Biomech.2010;43(9):1702-1707.
[42]Kopf S, Musahl V, Tashman S,et al. A systematic review of the femoral origin and tibial insertion morphology of the ACL[J]. Knee Surg Sports Traumatol Arthrosc.2009; 17(3): 213-219.
[1]Khalfayan EE, Sharkey PF, Alexander AH,et al.The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction [J]. Am J Sports Med,1996,24(3):335-341.
[2]Kodali P, Yang S, Koh J,et al. Computer-assisted surgery for anterior cruciate ligament reconstruction[J]. Sports Med Arthrosc.2008; 16(2):67-76.
[3]Palmer I.On the injuries to the ligaments of the knee joint:A clinical study[J]. Acta Chir Scand Suppl.1938,53:1-28.
[4]Shelbourne KD,Facibene WA,Hunt JJ,et al.Radiographic and intraoperative intercondylar notch width measurements in men and women with unilateral and bilateral anterior cruciate ligament tears[J]. Knee Surg Sports Traumatol Arthrosc.1997;5(4):229-233.
[5]Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer[J]. Am J Sports Med.1995,23(6):694-701.
[6]张志强,卫小春,任步芳,等.股骨髁间窝宽度的放射学测量[J].中华放射学杂志,2003,37(12)：1140-1142.
[7]许维亚,金涛,向选平,等.股骨髁间窝宽度CT测量的方法及意义[J].生物骨科材料与临床研究,2008,5(5)：15-19.
[8]Charlton WPH, John TAS, Ciccotti MG,et al. Differences in Femoral Notch Anatomy between Men and Women:A Magnetic Resonance Imaging Study[J]. Am J Sports Med, 2002;30(3):329-333.
[9]Domzalsk M,Grzelak P,Gabos P,et al.Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients:analysis of intercondylar notch width using Magnetic Resonance Imaging[J]. Int Orthop.2010;34(5):703-707.
[10]Herzog RJ, Silliman JF, Hutton K,et al. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging[J]. Am J Sports Med.1994,22(2):204-10.
[11]Domzalsk M,Grzelak P,Gabos P,et al.Risk factors for Anterior Cruciate Ligament injury n skeletally immature patients:analysis of intercondylar notch width using Magnetic Resonance Imaging[J]. Int Orthop.2010;34(5):703-707.
[12]Shelbourne KD,Benner TR.Intercondylar notch width measurement differences between African American and white men and women with intact anterior cruciate ligament knees[J].Am J Sports Med.2007;35(8):1304-1307.
[13]Hoteya K, Kato Y, Motojima S,et al. Association between intercondylar notch narroICWg and bilateral anterior cruciate ligament injuries in athletes[J].Arch Orthop Trauma Surg. 2011,131(3):371-6.
[14]李健,董大翠, 余世勇,等.股骨髁间窝的应用解剖及其临床研究[J].中华实验外科杂志.2001,18(2)：140-141.
[15]许鹏,李彦林,陈文栋,等.MRI影像下股骨髁间窝三维数字化解剖数据与实体解剖测量值差异[J].中国组织工程研究与临床康复,2011,15(43)：8006-8009.
[16]陈文栋,李彦林,许鹏,等.基于MRI建立膝关节前交叉韧带三维数字化模型[J].中国组织工程研究与临床康复,2011,15(52)：9725-9728.
[17]潘哲尔,黄加张,顾湘杰,等.核磁共振影像膝关节三维有限元模型的建立[J].中国骨与关节损伤杂志,2006,21(4)：268-270.
[18]陈欣,熊岳山.基于二维轮廓的膝关节三维重建[J].计算机应用,2007,3(2)：683-685.
[19]胡岩君,余斌, 苏秀云,等.基于MRI、CT影像下膝关节及交叉韧带重建可视化的初步应用研究[J].中华创伤骨科杂志,2007,9(5)：469-472.
[20]Freedman KB, D'Amato MJ, Nedeff DD, et al. Arthroscopic anterior cruciate ligament reconstruction:a meta-analysis comparing patellar tendon and hamstring tendon autografts[J]. Am J Sports Med.2003; 31(1):2-11.
[21]Plaweski S, Pearle A, Granchi C, et al. PRAXIM ACL navigation system using Bone Morphing. In:Navigation and MIS in Orthopedic Surgery[J]. Berlin:Springer,2006:306-332.
[22]Paessler HH, Mastrokalos DS. Anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons, bone patellar tendon, or quadriceps tendon graft with press-fit fixation without hardware. A new and innovative procedure[J]. Orthop Clin North Am,2003,34(1):49-64.
[23]Hamer CD,Giffin JR,Dunterman RC,et al. Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction. [J] Instr Course Lect.2001;50:463-474.
[24]Ellermann A, Sielbold R. ACL reconstruction with the Navitrack system:critical analysis of navigation in ACL surgery[J]. Berlin:Springer,2004:423-429.
[25]Shafizadeh S,Huber HJ,Grote S,et al. Principles of fluoroscopic-based navigation in anterior cruciate ligament reconstruction. Oper Tech Orthop,2005;15(1):70-75.
[26]Howell SM, Gittins ME,Gottlieb JE,et al.The relationship between the angle of the tibial tunnel in the coronal plane and loss of flexion and anterior laxity after anterior cruciate ligament reconstruction. Am J Sports Med,2001;29(5):567-574.
[27]Shafizadeh S,Huber HJ,Grote S,et al. Principles of fluoroscopic-based navigation in anterior cruciate ligament reconstruction. Oper Tech Orthop,2005;15(1):70-75.
[28]Katsuragi R, Yasuda K, Tsujino J,et al. The effect of non-physiologically high initial tension on the mechanical properties of in situ frozen anterior cruciate ligament in a canine model. Am J Sports Med,2000;28(1):47-56.
[29]Kodali P, Yang S, Koh J. Computer-assisted surgery for anterior cruciate ligament reconstruction. Sports Med Arthrosc.2008; 16(2):67-76.
[30]罗浩,敖英芳,王海军,等.膝关节前交叉韧带前内束和后外束股骨止点位置的解剖研究[J].中华关节外科杂志,2012,6(1)：97-103.
[31]王健全,敖英芳,刘平,等.前交叉韧带股骨止点临床解剖学研究[J].中国运动医学杂志,2007,26(3)：266-270.
[32]van Eck CF, Lesniak BP, Schreiber VM,et al. Anatomic single-and double-bundle anterior cruciate ligament reconstruction flowchart[J].Arthroscopy.2010,26(2):258-68.
[2]Shelbourne KD,Facibene WA,Hunt JJ,et al.Radiographic and intraoperative intercondylar notch width measurements in men and women with unilateral and bilateral anterior cruciate ligament tears[J]. Knee Surg Sports Traumatol Arthrosc.1997;5(4):229-233.
[3]Domzalsk M,Grzelak P,Gabos P,et al.Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients:analysis of intercondylar notch width using Magnetic Resonance Imaging[J]. Int Orthop.2010;34(5):703-707.
[4]肖德明.计算机辅助骨科导航技术面临的主要问题.中华创伤骨科杂志,2005.7(7)：617-619.
[5]Langlotz F. Potential pitfalls of computer aided orthopedic surgery[J]. Injury,2004;35 (Suppl l):S-A17-23.
[6]肖湘,梁国穗.第一届自动化与计算机辅助矫形外科研讨会纪要[J].中华骨科杂志,2005,25(5)：319-320.
[7]Schiffers N,Schkonmodan E,Portheine F,et al.Planning and performance of orthopedic surgery with the help of individual templates[J]. Orthopade,2000;29(7):636-640.
[8]Alicea JA,Install JN,Scuder GR,et al.Comparetive analysis of outcome scores in Totall Knee Arthroplasty.62nd Annal Meeting of american Academy of OtrhoPeadic Surgeons[M].Orlando.USA,1995;220.
[9]陈欣,岳山.基于二维轮廓的膝关节三维重建[J].计算机应用,2007,3(2)：683-685.
[10]潘哲尔,黄加张,顾湘杰,等.核磁共振影像膝关节三维有限元模型的建立[J].中国骨与关节损伤杂志,2006,21(4)：268-270.
[11]Siu D,Rudan J, Weversr HW,et al. Femoral articular shape and geometry:A three-dimensional computerized analysis of the knee [J]. J Arthroplasty.1996; 11 (2):166-173.
[12]Heriberto OL,Carlos E,Rodrguez B.Intercondylar notch in degenerative arthritis of the knee[J].J Arthr Rel Surg,2005;21(3):294-302
[13]Hodler J, Yu JS, GoodlCW D,et al. MR arthrography of the hip:improved imaging of the acetabular labrum with histologic correlation in cadavers[J]. Am J Roentgenol. 1995;165(4):887-891.
[14]许维亚,金涛,向选平,等.股骨髁间窝宽度CT测量的方法及意义[J].生物骨科材料与临床研究,2008；5(5)：15-19.
[15]张志强,卫小春,任步芳,等.股骨髁间窝宽度的放射学测量[J].中华放射学杂志,2003,37(12)：1140-1142.
[16]Van Eck CF,Martins CA,Kopf S,et al.Correlation between the 2-Dimensional notch width and the 3-Dimensional notch volume A cadaveric study[J]. Arthroscopy.2011;27(2):207-212.
[17]Hirokawa S,Tsuruno R.Three-dimensional deformation and stress distribution in an analytical/computational model of the anterior cruciate ligament[J].J Biomech.2000;33(9): 1069-1077.
[18]Osterhoff G,Loffler S,Steinke H,et al.Comparative anatomical measurements of osseous structures in the ovine and human knee[J].Knee.2011;18(2):98-103.
[19]Shelbourne KD, Kerr B. The relationship of femoral intercondylar notch width to height, weight, and sex in patients with intact anterior cruciate ligaments [J]. Am J Knee Surg.2001; 14(2):92-96.
[20]Charlton WPH, John TAS, Ciccotti MG,et al. Differences in Femoral Notch Anatomy between Men and Women:A Magnetic Resonance Imaging Study[J]. Am J Sports Med, 2002;30(3):329-333.
[21]Anderson AF,LipscombAB,Liudahl KJ,et al. Analysis of the intercondylar notch by computed tomography[J]. Am J Sports Med.1987; 15(6):547-552.
[22]Souryal TO, Moore HA,Evans JP. Bilaterality in anterior cruciate ligament injuries Associated intercondylar notch stenosis[J]. Am J Sports Med.1988; 16(5);449-454.
[23]袁峰,赵金忠.前交叉韧带重建术.见：赵金忠.膝关节重建外科学[M].河南：河南科学技术出版社,2007,1-13.
[24]Van Dijck RA, Saris DB, Willems JW, et al. Additional Surgery After Anterior Cruciate Ligament Reconstruction:Can We Improve Technical Aspects of the Initial Procedure? [J].Arthroscopy.2008;24(1):88-95.
[25]韩晓鹏,纪斌平.前交叉韧带重建技术的进展[J].国际骨科学杂志.2008,29(3)：173-176.
[26]Farrow LD, Chen MR, Cooperman DR,et al. Morphology of the Femoral Intercondylar Notch[J]. J Bone Joint Surg Am.2007;89(10):2150-2155.
[27]Pape D, Seil R, Adam F, et al. Blood loss in anterior cruciate ligament (ACL) reconstruction with and without intercondylar notchplasty:does it affect the clinical outcome? [J].Arch Orthop Trauma Surg,2001;121(10):574-577.
[28]Shelbourne KD, DavisTJ,Klootwyk TE. The Relationship Between Intercondylar Notch Width of the Femur and the Incidence of Anterior Cruciate Ligament Tears:A Prospective Study[J]. Am J Sports Med,1998; 16(3):402-408.
[29]Shelbourne KD,Benner TR.Intercondylar notch width measurement differences between African American and white men and women with intact anterior cruciate ligament knees[J].Am J Sports Med.2007;35(8):1304-1307.
[30]Dienst M, Schneider G, Altmeyer K, et al.Correlation of intercondylar notch cross sections to the ACL size:a high resolution MR tomographic in vivo analysis[J]. Arch Orthop Trauma Surg.2007;127(4):253-60.
[31]Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction [J]. J Bone Joint Surg Am.1985;67(2):257-62.
[32]Herzog RJ, Silliman JF, Hutton K,et al. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging[J]. Am J Sports Med.1994;22(2):204-10.
[33]Souryal TO, Freemen TR. Intercondylar notch size and anterior cruciate ligament injuries in athletesA prospective study[J]. Am J Sports Med.1993;21(4):535-539.
[34]Tillman MD, Smith KR, Bauer JA, et al.Differences in three intercondylar notch geometry indices between males and females:acadaver study[J].Knee.2002;9(1):41-46.
[35]Teitz CC, Lind BK, Sacks BM. Symmetry of the femoral notch width index [J]. Am J Sports Med.1997;25(5):687-90.
[36]Muneta T, Takakuda K, Yamamoto H.Intercondylar notch width and its relation to the configuration and cross-sectional area of the anterior cruciate ligament. A cadaveric knee study[J].Am J Sports Med.1997;25(1):69-72.
[37]邓军,梁碧玲,陈建宇,等.股骨髁间窝和前交叉韧带断面的3D TSE MRI测量[J].中国骨与关节损伤杂志,2009,24(7)：589-591.
[38]Vergis A, Gillquisr J. Graft failure in intra-articular anterior cruciate ligament reconstructions: A review of the literature [J]. Arthroscopy.1995;11 (3):312-321.
[39]LaPrade RF, Terry GC,Montgomery RD, et al. The effects of aggressive notchplasty on the normal knee indogs[J]. Am J Sports Med.1998;26(2):193-200.
[40]Asahina S, Muneta T, Ezura Y, et al.Notchplasty in anterior cruciate ligament reconstruction: An Experimental Animal Study?Arthroscopy.2000; 16(2):165-172.
[41]Simon RA, Everhart JS, Nagaraja HN, et al. A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees[J], J Biomech.2010;43(9):1702-1707.
[42]Kopf S, Musahl V, Tashman S,et al. A systematic review of the femoral origin and tibial insertion morphology of the ACL[J]. Knee Surg Sports Traumatol Arthrosc.2009; 17(3): 213-219.
[1]Khalfayan EE, Sharkey PF, Alexander AH,et al.The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction [J]. Am J Sports Med,1996,24(3):335-341.
[2]Kodali P, Yang S, Koh J,et al. Computer-assisted surgery for anterior cruciate ligament reconstruction[J]. Sports Med Arthrosc.2008; 16(2):67-76.
[3]Palmer I.On the injuries to the ligaments of the knee joint:A clinical study[J]. Acta Chir Scand Suppl.1938,53:1-28.
[4]Shelbourne KD,Facibene WA,Hunt JJ,et al.Radiographic and intraoperative intercondylar notch width measurements in men and women with unilateral and bilateral anterior cruciate ligament tears[J]. Knee Surg Sports Traumatol Arthrosc.1997;5(4):229-233.
[5]Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer[J]. Am J Sports Med.1995,23(6):694-701.
[6]张志强,卫小春,任步芳,等.股骨髁间窝宽度的放射学测量[J].中华放射学杂志,2003,37(12)：1140-1142.
[7]许维亚,金涛,向选平,等.股骨髁间窝宽度CT测量的方法及意义[J].生物骨科材料与临床研究,2008,5(5)：15-19.
[8]Charlton WPH, John TAS, Ciccotti MG,et al. Differences in Femoral Notch Anatomy between Men and Women:A Magnetic Resonance Imaging Study[J]. Am J Sports Med, 2002;30(3):329-333.
[9]Domzalsk M,Grzelak P,Gabos P,et al.Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients:analysis of intercondylar notch width using Magnetic Resonance Imaging[J]. Int Orthop.2010;34(5):703-707.
[10]Herzog RJ, Silliman JF, Hutton K,et al. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging[J]. Am J Sports Med.1994,22(2):204-10.
[11]Domzalsk M,Grzelak P,Gabos P,et al.Risk factors for Anterior Cruciate Ligament injury n skeletally immature patients:analysis of intercondylar notch width using Magnetic Resonance Imaging[J]. Int Orthop.2010;34(5):703-707.
[12]Shelbourne KD,Benner TR.Intercondylar notch width measurement differences between African American and white men and women with intact anterior cruciate ligament knees[J].Am J Sports Med.2007;35(8):1304-1307.
[13]Hoteya K, Kato Y, Motojima S,et al. Association between intercondylar notch narroICWg and bilateral anterior cruciate ligament injuries in athletes[J].Arch Orthop Trauma Surg. 2011,131(3):371-6.
[14]李健,董大翠, 余世勇,等.股骨髁间窝的应用解剖及其临床研究[J].中华实验外科杂志.2001,18(2)：140-141.
[15]许鹏,李彦林,陈文栋,等.MRI影像下股骨髁间窝三维数字化解剖数据与实体解剖测量值差异[J].中国组织工程研究与临床康复,2011,15(43)：8006-8009.
[16]陈文栋,李彦林,许鹏,等.基于MRI建立膝关节前交叉韧带三维数字化模型[J].中国组织工程研究与临床康复,2011,15(52)：9725-9728.
[17]潘哲尔,黄加张,顾湘杰,等.核磁共振影像膝关节三维有限元模型的建立[J].中国骨与关节损伤杂志,2006,21(4)：268-270.
[18]陈欣,熊岳山.基于二维轮廓的膝关节三维重建[J].计算机应用,2007,3(2)：683-685.
[19]胡岩君,余斌, 苏秀云,等.基于MRI、CT影像下膝关节及交叉韧带重建可视化的初步应用研究[J].中华创伤骨科杂志,2007,9(5)：469-472.
[20]Freedman KB, D'Amato MJ, Nedeff DD, et al. Arthroscopic anterior cruciate ligament reconstruction:a meta-analysis comparing patellar tendon and hamstring tendon autografts[J]. Am J Sports Med.2003; 31(1):2-11.
[21]Plaweski S, Pearle A, Granchi C, et al. PRAXIM ACL navigation system using Bone Morphing. In:Navigation and MIS in Orthopedic Surgery[J]. Berlin:Springer,2006:306-332.
[22]Paessler HH, Mastrokalos DS. Anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons, bone patellar tendon, or quadriceps tendon graft with press-fit fixation without hardware. A new and innovative procedure[J]. Orthop Clin North Am,2003,34(1):49-64.
[23]Hamer CD,Giffin JR,Dunterman RC,et al. Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction. [J] Instr Course Lect.2001;50:463-474.
[24]Ellermann A, Sielbold R. ACL reconstruction with the Navitrack system:critical analysis of navigation in ACL surgery[J]. Berlin:Springer,2004:423-429.
[25]Shafizadeh S,Huber HJ,Grote S,et al. Principles of fluoroscopic-based navigation in anterior cruciate ligament reconstruction. Oper Tech Orthop,2005;15(1):70-75.
[26]Howell SM, Gittins ME,Gottlieb JE,et al.The relationship between the angle of the tibial tunnel in the coronal plane and loss of flexion and anterior laxity after anterior cruciate ligament reconstruction. Am J Sports Med,2001;29(5):567-574.
[27]Shafizadeh S,Huber HJ,Grote S,et al. Principles of fluoroscopic-based navigation in anterior cruciate ligament reconstruction. Oper Tech Orthop,2005;15(1):70-75.
[28]Katsuragi R, Yasuda K, Tsujino J,et al. The effect of non-physiologically high initial tension on the mechanical properties of in situ frozen anterior cruciate ligament in a canine model. Am J Sports Med,2000;28(1):47-56.
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