The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction
The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction
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DOI：
10.1177/036354659602400315
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发表时间：
1996-05-01
影响因子：
4.8
通讯作者：
Bynum, EB
中科院分区：
文献类型：
--
作者：
Khalfayan, EE;Sharkey, PF;Bynum, EB
为了将前交叉韧带重建后的临床结果与放射学测量的隧道放置联系起来，我们前瞻性地研究了 128 名接受关节镜辅助骨-髌腱-骨重建的患者。双侧前十字韧带重建、其他严重膝关节韧带损伤或接受软骨成形术或半月板修复术的患者被排除，剩下 42 名患者。使用 Lysholm 评分、KT-1000 关节计测试、Tegner 活动水平以及枢轴移位和 Lachman 测试确定射线照相隧道位置与临床结果之间的关系。临床结果与侧位片上的后股骨隧道放置呈正相关，与过度的前胫骨隧道放置呈负相关。具体而言，当股骨隧道沿 Blumensaat 线向后至少 60%，胫骨隧道沿胫骨平台向后至少 20% 时，69% 的患者具有良好或优异的 Lysholm 评分，79% 的 KT-1000 关节计最大手动左右差异为 3 mm 或更小。当不满足上述标准时，50%的患者具有良好或优秀的Lysholm评分，22%的患者KT-1000关节计最大手动侧向差异为3毫米或更小。这种密切相关性表明，令人满意的射线照相隧道位置会影响前十字韧带重建后的结果。
To correlate clinical results after anterior cruciate ligament reconstruction with tunnel placement measured radiographically, we prospectively studied 128 patients who had arthroscopically assisted bone-patellar tendon-bone reconstructions. Patients with bilateral anterior cruciate ligament reconstructions, other significant knee ligament injuries, or those undergoing chondroplasty or meniscal repairs were excluded, leaving 42 patients. The relationship between radiographic tunnel position and clinical results was determined using the Lysholm score, KT-1000 arthrometer testing, the Tegner activity level, and the pivot shift and Lachman tests. Clinical results correlated positively with posterior femoral tunnel placement on lateral radiographs and negatively with excessive anterior tibial tunnel placement. Specifically, when femoral tunnels were placed at least 60% posterior along Blumensaat's line and tibial tunnels were at least 20% posterior along the tibial plateau, 69% of patients had good or excellent Lysholm scores and 79% had KT-1000 arthrometer maximum manual side-to-side differences of 3 mm or less. When the above criteria were not met, 50% of patients had good or excellent Lysholm scores and 22% had KT-1000 arthrometer maximum manual side-to-side differences of 3 mm or less. This close correlation indicates that satisfactory radiographic tunnel position influences outcome after anterior cruciate ligament reconstruction.