Clinical outcome of anatomic double-bundle ACL reconstruction and 3D CT model-based validation of femoral socket aperture position.
Clinical outcome of anatomic double-bundle ACL reconstruction and 3D CT model-based validation of femoral socket aperture position.
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解剖双束 ACL 重建和基于 3D CT 模型的股骨窝孔径位置验证的临床结果。
DOI：
10.1007/s00167-013-2663-0
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Nakagawa T.
中科院分区：
文献类型：
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作者：
Taketomi S;Inui H;Nakamura K;Hirota J;Sanada T;Masuda H;Takeda H;Tanaka S;Nakagawa T.
目的本研究的目的是评估解剖双束（DB）前交叉韧带（ACL）重建的临床结果，其中股骨窝孔的解剖位置进行了验证，使用三维（3D）计算机断层扫描（CT）modeling.MethodsAnatomic DB ACL重建与自体腘绳肌移植在34例患者。在术中3D透视导航的辅助下，通过外侧髁间嵴后面的远前内侧（AM）入路创建两个股骨窝。术后使用3D CT图像对所有患者的股骨隧道开口定位进行了研究。结果采用象限法测量3D CT图像上AM和后外侧（PL）股骨窝的位置，结果显示AM窝孔中心位于21.0 ± 4.1%的深度和30.5 ± 9.3%的高度PL窝口深度为31.3 ± 5.8%，高度为57.2 ± 7.7%。根据先前检查ACL股骨插入部位位置的尸体研究，认为股骨窝位置符合解剖学。主观评分平均为96.9 ± 4.0分。根据IKDC最终客观评分，26个膝关节（76%）客观分级为正常，8个（24%）为接近正常，0个（0%）为异常或严重异常。用KT-2000关节测量仪测量的术后侧到侧前平移平均为0.7 ± 1.2 mm.ConclusionsDB ACL重建，其中股骨窝孔在解剖学上使用3D CT进行验证，提供了令人满意的短期结果。
PurposeThe purpose of this study was to evaluate the clinical results of anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in which anatomic position of femoral socket apertures was validated using three-dimensional (3D) computed tomography (CT) modelling.MethodsAnatomic DB ACL reconstructions with hamstring autografts were performed in 34 patients. Two femoral sockets were created through a far anteromedial (AM) portal behind the lateral intercondylar ridge with the assistance of intraoperative 3D fluoroscopic navigation. Femoral tunnel aperture positioning was investigated postoperatively using 3D CT images in all patients. Clinical results were also evaluated subjectively and objectively at least up to 2 years.ResultsMeasurement of the AM and the posterolateral (PL) femoral socket locations on the 3D CT images using the quadrant method showed that the centre of the AM socket aperture was located at a depth of 21.0 ± 4.1 % and a height of 30.5 ± 9.3 % and that of the PL socket aperture was located at a depth of 31.3 ± 5.8 % and a height of 57.2 ± 7.7 %. The femoral socket locations were considered as anatomic in accordance with previous cadaveric studies examining the positions of ACL femoral insertion site. Subjectively, the mean Lysholm score was 96.9 ± 4.0 points. According to IKDC final objective scores, 26 knees (76 %) were objectively graded as normal, 8 (24 %) as nearly normal, and 0 (0 %) as abnormal or severely abnormal. Postoperative side-to-side anterior translation measured with a KT-2000 arthrometer averaged 0.7 ± 1.2 mm.ConclusionsDB ACL reconstructions in which femoral socket apertures were validated anatomically using 3D CT provided satisfactory short-term results.Level of evidenceCase series, Level IV.