Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, South Korea.
Arthroscopy. 2011 Oct;27(10):1389-94. doi: 10.1016/j.arthro.2011.06.013. Epub 2011 Sep 1.
We aimed to compare the modified transtibial and anteromedial (AM) portal techniques of anterior cruciate ligament reconstruction with respect to femoral tunnel position and length, as well as to identify factors associated with tunnel length.
After exclusions, 105 primary anterior cruciate ligament reconstructions (55 in transtibial group and 50 in AM portal group) were studied. Femoral tunnel positions were assessed on postoperative tunnel-view radiographs, and tunnel lengths were measured during surgery. Differences between femoral tunnel positions in the coronal plane and lengths in these 2 groups were examined, and factors associated with tunnel lengths were investigated.
The AM portal group had a significantly more oblique femoral tunnel position than the transtibial group. However, femoral tunnels in the AM portal group were substantially shorter than tunnels in the transtibial group (34.2 v 43.3 mm, P < .001); the proportions of knees with femoral tunnels measuring less than 30 mm in the AM portal and transtibial groups were 26% and only 2%, respectively. In addition, a more oblique femoral tunnel position and a shorter distal femur mediolateral width were found to be significantly associated with a shorter femoral tunnel.
This study shows that the AM portal technique can achieve a more oblique femoral tunnel position but that resultant tunnels are substantially shorter than tunnels produced by the modified transtibial technique.
我们旨在比较改良经胫骨和前内侧（AM）入路前交叉韧带重建术的股骨隧道位置和长度，并确定与隧道长度相关的因素。
排除后，共研究了 105 例初次前交叉韧带重建（胫骨组 55 例，AM 入路组 50 例）。术后隧道位片评估股骨隧道位置，术中测量隧道长度。检查这 2 组冠状位股骨隧道位置和长度的差异，并探讨与隧道长度相关的因素。
AM 入路组股骨隧道位置明显更偏斜。然而，AM 入路组的股骨隧道明显短于胫骨组（34.2 比 43.3 毫米，P <.001）；AM 入路组和胫骨组中股骨隧道长度小于 30 毫米的膝关节比例分别为 26%和 2%。此外，发现股骨隧道位置越偏斜，股骨远端内外侧宽度越短，股骨隧道越短。
本研究表明，AM 入路技术可获得更偏斜的股骨隧道位置，但产生的隧道明显短于改良经胫骨技术。
