Schoderbek Robert J, Golish S Raymond, Rubino L Joseph, Oliviero Jason A, Hart Joseph M, Miller Mark D
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.
J Knee Surg. 2009 Apr;22(2):106-10. doi: 10.1055/s-0030-1247733.
This study compared the graft/femoral tunnel angle produced with the outside-in technique with the inside-out technique at 90 degrees and 120 degrees of flexion. Three femoral tunnels were marked with guidewires and measured radiographically in 8 fresh-frozen cadaveric knees using both techniques. Results were analyzed. The mean graft/femoral tunnel angle was 34.4 degrees +/- 14.4 degrees for the outside-in technique, 52.3 degrees +/- 14.1 degrees for the inside-out technique at 120 degrees of flexion, and 74.4 degrees +/- 11 degrees for the inside-out technique at 90 degrees of flexion. The angle was smaller for the outside-in technique versus the inside-out technique at both 120 degrees (P = .019) and 90 degrees of knee flexion (P < .001). The outside-in technique for femoral tunnel placement produces the lowest graft/femoral tunnel angle in cadavers. With the inside-out technique, 120 degrees of flexion produces smaller angles than does 90 degrees of flexion. The outside-in technique results in lower angles and perhaps lower graft failure rates. However, additional clinical studies are needed.
本研究比较了采用由外向内技术和由内向外技术在膝关节屈曲90度和120度时所产生的移植物/股骨隧道角度。在8个新鲜冷冻尸体膝关节中，使用这两种技术通过导丝标记3个股骨隧道并进行影像学测量。对结果进行分析。在膝关节屈曲120度时，由外向内技术的平均移植物/股骨隧道角度为34.4度±14.4度，由内向外技术为52.3度±14.1度；在膝关节屈曲90度时，由内向外技术的平均移植物/股骨隧道角度为74.4度±11度。在膝关节屈曲120度（P = 0.019）和90度（P < 0.001）时，由外向内技术的角度均小于由内向外技术。在尸体中采用由外向内技术进行股骨隧道置入时产生的移植物/股骨隧道角度最小。采用由内向外技术时，膝关节屈曲120度时产生的角度小于屈曲90度时。由外向内技术导致的角度更低，可能移植物失败率也更低。然而，还需要更多的临床研究。
