He Chuan, Li Yanlin, Zhang Zhenguang, Wang Guoliang, Wang Fuke, Cao Shuhai, Wang Huijian, Zhao Fengkai
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Dec;27(12):1432-6.
To evaluate the feasibility and effectiveness of computer-assisted preoperative planning system-ACL Detector in anterior cruciate ligament (ACL) reconstruction.
Between March 2009 and January 2012, 80 patients with ACL rupture received arthroscopic ACL single-bundle reconstruction with autologous hamstring tendon transplantation. Before operation, the preoperative planning was done by computer-assisted preoperative planning system-ACL Detector (trial group, n=40) or by conventional method (control group, n=40). There was no significant difference in gender, age, disease duration, injury cause, preoperative Lysholm score, and preoperative International Knee Documentation Committee (IKDC) score between 2 groups (P > 0.05). After operation, the effectiveness was evaluated by Lachman test, pivot shift test, Lysholm score, and IKDC score; the digital three-dimensinal model of knee was reconstructed, and the impingement rate of ACL graft was measured.
All incisions healed by first intention, and no complication was found. The patients were followed up 18-25 months (mean, 20 months) in trial group and 18-24 months (mean, 21 months) in control group. The Lysholm score and IKDC score were significantly increased at 18 months after operation when compared with preoperative scores (P < 0.05), but no significant difference was found between 2 groups (P > 0.05). The results of Lachman test and pivot shift test at 18 months after operation were significantly better than those before operation in 2 groups (P < 0.05), but no significant difference between 2 groups after operation (P > 0.05). MRI showed that impingement was observed in 1 case of trial group (2.50%) and in 8 cases of control group (20.00%), showing significant difference (chi2=4.51, P=0.03).
The computer-assisted preoperative planning system-ACL Detector could be successfully applied to ACL reconstruction. It has the same improvement in knee functional score as conventional surgery, but it is better than conventional surgery in reducing the impingement incidence.
评估计算机辅助术前规划系统-前交叉韧带探测器（ACL探测器）在前交叉韧带（ACL）重建中的可行性和有效性。
2009年3月至2012年1月，80例ACL断裂患者接受了关节镜下自体腘绳肌腱移植单束ACL重建术。术前，通过计算机辅助术前规划系统-ACL探测器进行术前规划（试验组，n = 40）或采用传统方法（对照组，n = 40）。两组在性别、年龄、病程、损伤原因、术前Lysholm评分和术前国际膝关节文献委员会（IKDC）评分方面无显著差异（P>0.05）。术后，通过Lachman试验、轴移试验、Lysholm评分和IKDC评分评估有效性；重建膝关节的数字三维模型，并测量ACL移植物的撞击率。
所有切口均一期愈合，未发现并发症。试验组随访18 - 25个月（平均20个月），对照组随访18 - 24个月（平均21个月）。术后18个月时，Lysholm评分和IKDC评分与术前评分相比显著提高（P<0.05），但两组间无显著差异（P>0.05）。术后18个月时，两组的Lachman试验和轴移试验结果均明显优于术前（P<0.05），但术后两组间无显著差异（P>0.05）。MRI显示，试验组1例（2.50%）出现撞击，对照组8例（20.00%）出现撞击，差异有统计学意义（χ2 = 4.51，P = 0.03）。
计算机辅助术前规划系统-ACL探测器可成功应用于ACL重建。其在膝关节功能评分方面与传统手术有相同的改善，但在降低撞击发生率方面优于传统手术。
