Femoral Tunnel Placement During Anterior Cruciate Ligament Reconstruction An In Vivo Imaging Analysis Comparing Transtibial and 2-Incision Tibial Tunnel-Independent Techniques
Femoral Tunnel Placement During Anterior Cruciate Ligament Reconstruction An In Vivo Imaging Analysis Comparing Transtibial and 2-Incision Tibial Tunnel-Independent Techniques
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DOI：
10.1177/0363546509340768
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发表时间：
2009-10-01
影响因子：
4.8
通讯作者：
DeFrate, Louis E.
中科院分区：
文献类型：
--
作者：
Abebe, Ermias S.;Moorman, C. T., III;DeFrate, Louis E.
工作背景：最近的研究质疑经胫骨技术将前交叉韧带移植物放置在股骨前交叉韧带足迹内的能力。直接比较经胫骨和胫骨隧道独立技术在前交叉韧带股骨附着点解剖放置移植物的能力的数据有限。假设：由于胫骨隧道独立技术的放置不受胫骨隧道的限制，与经胫骨技术相比，它允许更多的解剖隧道放置。证据等级，3.方法：采用高分辨率、多平面磁共振成像和先进的三维建模技术，测量8例经胫骨技术和8例胫骨隧道独立技术患者的体内股骨隧道位置。在3个维度的股骨隧道放置测量相对于本地前交叉韧带附件的中心在完整的对侧knee.Results：胫骨隧道独立的技术放置移植物更接近本地前交叉韧带附件的中心相比，transtibial技术。经胫骨技术将隧道中心放置在距离前交叉韧带附着点中心平均9 mm的位置，而胫骨隧道独立技术的平均距离为3 mm。transtibial技术导致更前和上级放置的隧道相比，胫骨隧道独立technology.Conclusion：胫骨隧道独立技术允许更多的解剖股骨隧道放置相比，transtibial技术。
Background: Recent studies have questioned the ability of the transtibial technique to place the anterior cruciate ligament graft within the footprint of the anterior cruciate ligament on the femur. There are limited data directly comparing the abilities of transtibial and tibial tunnel-independent techniques to place the graft anatomically at the femoral attachment site of the anterior cruciate ligament in patients.Hypothesis: Because placement with the tibial tunnel-independent technique is unconstrained by the tibial tunnel, it would allow for more anatomic tunnel placement compared with the transtibial technique.Study Design: Cross-sectional study; Level of evidence, 3.Methods: High-resolution, multiplanar magnetic resonance imaging and advanced 3-dimensional modeling techniques were used to measure in vivo femoral tunnel placement in 8 patients with the transtibial technique and 8 patients with a tibial tunnel independent technique. Femoral tunnel placement in 3 dimensions was measured relative to the center of the native anterior cruciate ligament attachment on the intact contralateral knee.Results: The tibial tunnel-independent technique placed the graft closer to the center of the native anterior cruciate ligament attachment compared with the transtibial technique. The transtibial technique placed the tunnel center an average of 9 mm from the center of the anterior cruciate ligament attachment, compared with 3 mm for the tibial tunnel-independent technique. The transtibial technique resulted in a more anterior and superior placement of the tunnel compared with the tibial tunnel independent technique.Conclusion: The tibial tunnel-independent technique allowed for more anatomic femoral tunnel placement compared with the transtibial technique.