经皮外向内与经胫骨双束前交叉韧带重建术中股骨隧道扩大情况的比较
Comparison of femoral tunnel widening between outside-in and trans-tibial double-bundle ACL reconstruction.
作者信息
Lee Yong Seuk, Lee Beom Koo, Oh Won Seok, Cho Yong Kyun
机构信息
Department of Orthopedic Surgery, School of Medicine, Gil Hospital, Gachon University, Incheon, Korea,
出版信息
Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2033-9. doi: 10.1007/s00167-013-2597-6. Epub 2013 Jul 13.
PURPOSE
The objectives of this study were to compare (1) the degree of widening by comparing the diameter at the most widened area and the site of widening by measuring the distance from the tunnel entrance to the most widened area in two femoral tunnels (anteromedial and posterolateral), and (2) the morphologic change at the tunnel entrance between outside-in and trans-tibial double-bundle anterior cruciate ligament (ACL) reconstruction.
METHODS
A retrospective study that included 17 trans-tibial and 19 outside-in double-bundle ACL reconstructed patients was conducted for evaluation of serial computed tomography (CT) scan (immediate post-operation and post-operative 1 year). Digital image communication in medicine (DICOM) data was extracted from the PiViewSTAR and imported into OsiriX, which was installed on a Macbook Pro laptop computer. Diameter of the most widened area and distance from the entrance to this point were measured from each of two perpendicular (sagittal and coronal) planes that were accurately realigned parallel to the tunnel direction. Change in the morphology of the tunnel entrance between immediate post-operation and 1-year post-operation was evaluated.
RESULTS
Widening was observed in both planes of both tunnels in the two techniques. However, no statistical significances in the diameter of most widened area and distance from the tunnel entrance to the most widened point were observed between the both techniques (n.s.). Distances from the centre point to each four sections showed an increase in all four sections of all both tunnels in both techniques. However, no statistical significance was observed between the two techniques (n.s.).
CONCLUSION
Widening was observed in all tunnels using both techniques and degrees, and sites of the widening did not differ between groups. Morphologic change at the tunnel entrance was not limited to the specific direction and occurred in all directions without significant difference between groups.
LEVEL OF EVIDENCE
Retrospective comparative study, Level III.
目的
本研究的目的是比较：（1）通过测量两个股骨隧道（前内侧和后外侧）中最宽处的直径以及从隧道入口到最宽处的距离来比较加宽程度，以及（2）在由外向内和经胫骨双束前交叉韧带（ACL）重建中隧道入口处的形态变化。
方法
进行一项回顾性研究，纳入17例经胫骨和19例由外向内双束ACL重建患者，以评估系列计算机断层扫描（CT）（术后即刻和术后1年）。从PiViewSTAR中提取医学数字图像通信（DICOM）数据，并导入安装在MacBook Pro笔记本电脑上的OsiriX中。从与隧道方向精确平行对齐的两个垂直（矢状面和冠状面）平面中测量每个最宽处的直径以及从入口到该点的距离。评估术后即刻和术后1年之间隧道入口形态的变化。
结果
在两种技术的两个隧道的两个平面中均观察到加宽。然而, 两种技术之间在最宽处的直径以及从隧道入口到最宽点的距离方面均未观察到统计学意义（无显著性差异）。两种技术中，从中心点到所有两个隧道的所有四个节段的距离在所有四个节段均显示增加。然而，两种技术之间未观察到统计学意义（无显著性差异）。
结论
使用两种技术在所有隧道中均观察到加宽，且加宽的程度和部位在组间无差异。隧道入口处的形态变化不限于特定方向，而是在所有方向均发生，且组间无显著差异。
证据水平
回顾性比较研究，III级。
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