Orthopedics Department, Hospital Militar D. Pedro V, Avenida da Boavista, 4050-113, Porto, Portugal.
Knee Surg Sports Traumatol Arthrosc. 2012 May;20(5):896-903. doi: 10.1007/s00167-011-1645-3. Epub 2011 Aug 18.
The purpose of this study was to compare the transtibial reconstruction technique of the anterior cruciate ligament (ACL) with the anteromedial (AM) portal technique in their ability to place the femoral and tibial tunnels within the ACL footprints.
Forty patients were sequentially enrolled in two different surgical techniques, 20 patients in the transtibial and 20 patients in the AM portal technique. All patients underwent computed tomography scan of the operated knee. The center of the femoral tunnel aperture on the lateral femoral condyle was measured according to the quadrant method. On the tibial side, the center of the tibial tunnel was measured in the sagittal plane. These measurements were compared with the center of the normal AM and PL bundles.
There were no differences in the center of the femoral tunnels on the Blumensaat's line between the two groups (mean 23.5% (4.2) for the transtibial technique and 26.0% (4.3) for the AM portal technique (P = n.s.). In the height of the femoral condyle, the center of the tunnels was significantly lower in the AM portal technique group [mean 34.7% (3.8) vs. 24.0% (7.9) (P < 0.001)]. In the tibia, the center of the tunnel in the sagittal plane was significantly posterior in the transtibial technique (mean 55.4% (4.9) vs. 44.4% (3.7) (P < 0.001).
The AM portal technique places the femoral and tibial tunnels more centrally in the ACL footprint when compared with the transtibial technique.
II.
本研究旨在比较前交叉韧带（ACL）经胫骨重建技术与前内侧（AM）入路技术在ACL 附着点内放置股骨和胫骨隧道的能力。
40 例患者先后纳入两种不同的手术技术，20 例经胫骨，20 例经 AM 入路。所有患者均接受膝关节 CT 扫描。根据象限法测量外侧股骨髁股骨隧道开口中心。胫骨侧，测量矢状面胫骨隧道中心。将这些测量值与正常 AM 和 PL 束中心进行比较。
两组间 Blumensaat 线上股骨隧道中心无差异（胫骨技术组平均 23.5%（4.2），AM 入路技术组 26.0%（4.3）（P=n.s.）。在股骨髁高度上，AM 入路技术组隧道中心明显较低[平均 34.7%（3.8）比 24.0%（7.9）（P<0.001）]。在胫骨上，胫骨隧道矢状面中心在经胫骨技术中明显更靠后（平均 55.4%（4.9）比 44.4%（3.7）（P<0.001））。
与经胫骨技术相比，AM 入路技术可使股骨和胫骨隧道更靠近 ACL 附着点。
II 级。
