Horie Masafumi, Muneta Takeshi, Yamazaki Junya, Nakamura Tomomasa, Koga Hideyuki, Watanabe Toshifumi, Sekiya Ichiro
Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):981-5. doi: 10.1007/s00167-013-2781-8. Epub 2013 Nov 28.
A modified quadrant method was developed for description of femoral tunnel aperture positions on the sagittal plane after double-bundle anterior cruciate ligament (ACL) reconstruction, which can be measured by using two-view radiographs. The purpose of the study is to provide a new measurement method and to evaluate the reproducibility and accuracy of the method.
Forty-one patients who had undergone a double-bundle ACL reconstruction were investigated. Two-view plain radiographs, a 45-degree-flexion posterior-anterior standing (Rosenberg) and a lateral view, were taken at 1 year postoperatively, and the femoral tunnel positions were measured. Intra- and inter-observer reproducibility was calculated by means of intra-class correlation coefficient (ICC). Also, the accuracy of the method was evaluated by comparing the measurement from three-dimensional computed tomography (3D-CT).
Intra-observer reproducibility was excellent (ICC > 0.9). Inter-observer reproducibility of antero-medial (AM) tunnel position was almost perfect (ICC > 0.8) and that of postero-lateral (PL) tunnel was substantial (ICC > 0.7). The accuracy of the method was assessed by comparing the measurement from 3D-CT and was found to be almost perfect (ICC > 0.8). With the modified quadrant method, the average height of AM and PL tunnels were 17.8 and 44.4 %, respectively, and the depth of AM and PL tunnels were 25.5 and 36.7 %, respectively.
A modified quadrant method was found to have acceptable reproducibility and accuracy. The method is useful for describing the femoral tunnel aperture positions in ACL reconstruction because of its easiness and simplicity. By using this method, it is possible to analyse the femoral tunnel position even in the cases without CT analysis.
IV.
开发一种改良象限法，用于描述双束前交叉韧带（ACL）重建术后矢状面上股骨隧道开口位置，该位置可通过双视图X线片测量。本研究的目的是提供一种新的测量方法，并评估该方法的可重复性和准确性。
对41例行双束ACL重建的患者进行研究。术后1年拍摄双视图平片，即45度屈膝后前位站立（罗森伯格位）和侧位片，并测量股骨隧道位置。通过组内相关系数（ICC）计算观察者内和观察者间的可重复性。此外，通过与三维计算机断层扫描（3D-CT）测量结果进行比较来评估该方法的准确性。
观察者内可重复性极佳（ICC>0.9）。前内侧（AM）隧道位置的观察者间可重复性几乎完美（ICC>0.8），后外侧（PL）隧道的可重复性较好（ICC>0.7）。通过与3D-CT测量结果比较评估该方法的准确性，发现几乎完美（ICC>0.8）。采用改良象限法，AM和PL隧道的平均高度分别为17.8%和44.4%，AM和PL隧道的深度分别为25.5%和36.7%。
改良象限法具有可接受的可重复性和准确性。该方法因其简便易行，可用于描述ACL重建中股骨隧道开口位置。使用该方法，即使在没有CT分析的情况下也有可能分析股骨隧道位置。
IV级。
