The effect of femoral tunnel starting position on tunnel length in anterior cruciate ligament reconstruction: A cadaveric study
The effect of femoral tunnel starting position on tunnel length in anterior cruciate ligament reconstruction: A cadaveric study
复制标题
DOI：
10.1016/j.arthro.2007.06.013
复制
发表时间：
2007-11-01
影响因子：
4.7
通讯作者：
Miller, Mark D.
中科院分区：
文献类型：
--
作者：
Golish, S. Raymond;Baumfeld, Joshua A.;Miller, Mark D.
目的：本尸体研究的目的是评价股骨隧道起始位置对股骨隧道长度的影响，并评价胫骨隧道起始位置对前交叉韧带（ACL）重建中股骨隧道起始位置的影响。方法：对7例新鲜冷冻尸体膝关节进行研究。将胫骨隧道放置在3个不同位置：前部放置、远内侧放置以及前部和远内侧放置之间的中间位置。使用5 mm偏心距导向器在4个不同位置放置股骨导丝：3个胫骨隧道各1个，前内侧关节镜入口1个。测量所形成的股骨隧道的深度和每个隧道的钟面位置。结果：股骨隧道与胫骨起始位置的平均时钟位置（点钟）和长度（mm）如下。胫骨前部：11：30点和61 mm，胫骨中点：10：50点和44 mm，胫骨远内侧：10：17点和37 mm，内侧关节镜入口：9：35点和23 mm，起始位置之间隧道长度差异有统计学意义，胫骨起始位置之间股骨起始位置差异有统计学意义。结论：隧道长度大于2 cm和10：30时开始位置可以通过胫骨隧道内侧放置来实现。从内侧关节镜入路放置可能导致股骨隧道位于10点钟方向更外侧，但可能短于2 cm。临床相关性：胫骨起始位置影响股骨在髁间窝中的起始位置。股骨起始位置影响股骨隧道长度。股骨起始位置和隧道长度是临床ACL重建的重要考虑因素。
Purpose: The purpose of this cadaveric study was to evaluate the effect of femoral tunnel starting position on femoral tunnel length and to evaluate the effect of tibial tunnel starting position on femoral tunnel starting position in anterior cruciate ligament (ACL) reconstruction. Methods: Seven fresh-frozen cadaver knees were studied. Tibial tunnels were placed at each of 3 different locations: anterior placement, far medial placement, and midway between the anterior and far medial placements. Femoral guidewires were placed using a 5-mm offset guide at each of 4 different locations: 1 from each of the 3 tibial tunnels and 1 from the anteromedial arthroscopic portal. The depth of the resultant femoral tunnels and the clock face location of each tunnel were measured. Results: The mean clock position (o'clock) and length (mm) of the femoral tunnel versus tibial starting position were as follows. Anterior tibia: 11:30 o'clock and 61 mm. Midpoint tibia: 10:50 o'clock and 44 mm. Far medial tibia: 10:17 o'clock and 37 mm. Medial arthroscopy portal: 9:35 o'clock and 23 mm. The differences in tunnel length between starting positions were statistically significant, and the differences in femoral starting position between tibial starting positions were statistically significant. Conclusions: Tunnel length greater than 2 cm and 10:30 o'clock starting position can be achieved by medial placement of the tibial tunnel. Placement from the medial arthroscopy portal can result in femoral tunnels more lateral than 10 o'clock, but they may be shorter than 2 cm. Clinical Relevance: Tibial starting position affects femoral starting position in the intercondylar notch. Femoral starting position affects femoral tunnel length. Femoral starting position and tunnel length are important considerations in clinical ACL reconstruction.