Anatomic Study On Treatment Of Avulsion Fracture Of Posterior Cruciate Ligament At Tibial Attachment With Proximal-posteromedial Portal Arthroscopy

Objective:The proximal-posteromedial portal arthroscopy is to be established on the cadaver specimens in order to understand the anatomical relationship between this approach and the surrounding important soft tissues and judge the safety and feasibility of this approach,so as to provide the anatomic basis for the clinical application of avulsion fracture of the posterior cruciate ligament at the tibial attachment with proximal-posteromedial portal arthroscopy.Methods:The simulated surgery is to be performed on 20 knee joint specimens of embalmed cadavers to establish a proximal-posteromedial portal arthroscopy and perform anatomy of the anterior medial side of the distal femur and popliteal fossa,preserving the continuity and integrity of important soft tissues,observing the anatomical relationship between kirschner wire and surrounding tissues and determining if there is the significant nerve and vascular damage caused by the puncture.Objective parameters are to be measured and the anatomic relationship between the approach and peripheral nerves,blood vessels and other soft tissues are to be recorded descriptively.The important links and discoveries can be recorded by taking photos.SPSS 22.0 statistical software is to be adopted for the data analysis,and the data is to be expressed as mean ± standard deviation(SX ±).Results:The simulated puncture of this approach was completed successfully in all the specimens and no significant neurovascular injury was caused by the puncture.The nearest distance between the puncture approach and popliteal artery,popliteal vein and tibial nerve was(16.46 ± 1.38)mm,(18.07 ± 1.32)mm,(20.99 ± 1.61)mm respectively,all within the safe distance range.Conclusions: The anatomy results of cadaver specimens have confirmed the safety and feasibility of the proximal-posteromedial portal arthroscopy preliminarily,but it is not possible to simulate clinical practice completely due to the limitations of embalmed cadavers,and needs to be confirmed further by the anatomy research of fresh cadavers and research of living body iconography.