Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction
Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction
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前交叉韧带重建中经胫骨技术与运输技术股骨移植物弯曲角度和隧道长度的比较
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发表时间：
2012
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通讯作者：
J. Ahn
中科院分区：
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作者：
J. Wang;J. Kim;Do Kyung Lee;Hong;J. Ahn
目的利用OsiriX®三维CT成像软件，比较单束(SB)经胫骨(TT)和双束(DB)经门静脉(TP)技术重建前交叉韧带(ACL)后股骨移植物的弯曲角度和隧道长度，探讨哪种技术可以减少前交叉韧带重建后股骨隧道口的弯曲应力，缩短隧道长度。用OsiriX®图像处理软件测量股骨移植物弯曲角和股骨隧道长度。结果II组移植股前内侧(AM)和后外侧(PL)的平均弯曲角度(分别为111.5°±28.8°和118.9°±99.8°)明显大于I组(125.3°±11.1°)(P<0.001)。结论前交叉韧带重建后，膝关节最大屈曲位下TP技术的股骨移植物弯曲角和股骨隧道长度均明显大于TT技术(P<0.001)。与TT技术相比，使用TP技术重建前交叉韧带可能会增加股骨隧道口处的弯曲应力，缩短隧道内的移植物长度。
PurposeTo investigate which technique would reduce bending stress at the femoral tunnel aperture and make short tunnel length after ACL reconstruction by comparing the femoral graft bending angle and tunnel length between the single-bundle (SB) transtibial (TT) and double-bundle (DB) transportal (TP) technique using three-dimensional-computed tomography using OsiriX® imaging software.MethodsForty-nine patients underwent an ACL reconstruction using a SB TT (Group I, 20 patients) and DB TP (Group II, 29 patients) technique. Femoral graft bending angle and femoral tunnel length were measured by CT image using OsiriX® imaging software. Groups I and II were compared, and statistical analysis was performed using SPSS software.ResultsThe mean anteromedial (AM) and posterolateral (PL) femoral graft bending angle of group II (111.5 ± 8.8° and 118.9 ± 9.8°, respectively) was significantly more acute than that of group I (125.3 ± 11.1°) (P < 0.001, P = 0.04). The mean femoral tunnel length of group I was significantly longer than that of group II (P = 0.001).ConclusionsThe femoral graft bending angle and the femoral tunnel length of the TP technique performed in the maximally flexed knee position was more acute and shorter than those of the TT technique after ACL reconstruction. This might increase the bending stress at the femoral tunnel aperture and shorter graft length in the tunnel after an ACL reconstruction using TP technique compared to the TT technique.Level of evidenceIII.