Comparison of sagittal obliquity of the reconstructed anterior cruciate ligament with native anterior cruciate ligament using magnetic resonance imaging
Comparison of sagittal obliquity of the reconstructed anterior cruciate ligament with native anterior cruciate ligament using magnetic resonance imaging
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DOI：
10.1053/jars.2003.50066
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发表时间：
2003-03-01
影响因子：
4.7
通讯作者：
Rondón, L
中科院分区：
文献类型：
--
作者：
Ayerza, MA;Múscolo, DL;Rondón, L
目的：本研究采用矢状面磁共振成像（MRI）比较无症状前交叉韧带（ACL）移植物与正常对照的倾斜程度。研究类型：病例对照研究。方法：回顾了30例重建前交叉韧带移植患者和30例完整前交叉韧带患者的矢状位mri。重建患者采用自体髌骨肌腱双切口技术进行手术。这些被选中的患者在KT-1000关节计测试中IKDC评分正常或接近正常，与完整的膝关节相比，前后移位不超过3mm。MRI显示植骨连续均匀，未见顶撞击。通过测量移植物线与胫骨平台平面的交点，在每个侧位MRI上确定移植物前交叉韧带的倾斜度。这些数据与30名膝关节稳定、前交叉韧带完好的患者的数据进行了比较，这些数据是通过病史和体格检查确定的。结果：重建患者的移植物倾斜度平均为67，范围为55 ~ 81。在正常对照中，完整的前交叉韧带倾角平均为51，范围在45 - 55之间。两组间差异有统计学意义（P < 0.0001）。结论：为避免切口撞击而适当放置胫骨隧道的患者的mri显示，与原始前交叉韧带相似的连续且均匀的移植物，但更垂直的移植物不能重建正常的矢状倾角。然而，根据关节计测试，这些更垂直的移植物可以控制膝关节前后移位。
Purpose: This study was conducted to compare the obliquity of asymptomatic anterior cruciate ligament (ACL) grafts with normal controls using sagittal magnetic resonance imaging (MRI). Type of Study: Case control study. Methods: Sagittal MRIs from 30 patients with a reconstructed ACL graft and from 30 individuals with an intact ACL were reviewed. Reconstructed patients were operated on with a 2-incision technique using a patellar tendon autograft. These selected patients had a normal or nearly normal IKDC score with a 3 mm or less anterior posterior translation on KT-1000 arthrometer testing compared with the intact knee. MRI showed a continuous and homogeneous graft without evidence of roof impingement. Obliquity of the grafted ACL was determined on each lateral MRI by measuring the intersection of the graft line with the tibial plateau plane. These figures were compared with data similarly obtained from 30 individuals with a stable knee and an intact ACL determined by history and physical examination. Results: Graft obliquity in reconstructed patients averaged 67 with a range between 55 and 81. In normal controls, intact ACL obliquity averaged 51 with a range between 45 and 55. The difference between the two groups was statistically significant (P < .0001). Conclusions: MRIs of patients with an appropriate tibial tunnel placement in order to avoid notch impingement showed a continuous and homogeneous graft similar to the native ACL, but with a more vertical graft that does not recreate the normal sagittal obliquity. However, according to arthrometer testing, these more vertical grafts can control anterior posterior knee displacement.