在非职业运动员前交叉韧带重建的短期随访中，与经胫骨入路相比，前内侧入路是否具有临床优势？
Does the anteromedial portal provide clinical superiority compared to the transtibial portal in anterior cruciate ligament reconstruction in nonprofessional athletes in short-term follow-up?
作者信息
Taşdemir Zeki, Gülabi Deniz, Sağlam Fevzi, Tokgöz Özal Safiye, Elmalı Nurzat
机构信息
Lütfi Kırdar Kartal Training and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Lütfi Kırdar Kartal Training and Research Hospital, Department of Radiology, İstanbul, Turkey.
出版信息
Acta Orthop Traumatol Turc. 2015;49(5):483-91. doi: 10.3944/AOTT.2015.15.0016.
OBJECTIVE
Two drilling techniques of the femoral tunnel are commonly used in anterior cruciate ligament (ACL) reconstruction: through the transtibial (TT) portal or through the anteromedial (AM) portal. The aim of the present study is to investigate the radiological and clinical outcomes of arthroscopic single-bundle ACL reconstruction using AM and TT portal techniques for drilling the femoral tunnel in nonprofessional athletes.
METHODS
A retrospective review was made of 44 nonprofessional athletes undergoing ACL reconstruction using AM and TT techniques between 2011-2013. The femoral tunnel clock position on axial magnetic resonance imaging (MRI) and the anterior-posterior position of the tibial tunnel on sagittal-cut MRI scan were measured. Radiological femoral tunnel and tibial tunnel anterior-posterior inclination angles were assessed. At final follow-up, the Lachman test and pivot-shift test were used in the evaluation of the anterior-posterior stability of the knee and the rotational stability of the knee. For clinical and functional evaluation, the modified Cincinnati knee grading system, Lysholm knee scoring scale, and International Knee Documentation Committee (IKDC) form were used.
RESULTS
No statistically significant difference was determined between the groups in terms of patient age, follow-up period, gender, and affected side distribution. There were 6 outliers in the TT group due to the clock face position. The mean femoral tunnel inclination angle was 31.07°±8.44° in the AM group and 19.02°±8.93° in the TT group. The tibial tunnel inclination angle was 21.08°±5.42° in the TT group and 16.58°±7.02° in the AM group. A statistically significant difference was determined between the 2 groups. No statistically significant difference was observed between the 2 groups in terms of Lachman test, pivot-shift test, Lysholm score, IKDC score, and modified Cincinnati score results.
CONCLUSION
The AM technique has no clinical superiority compared to the TT technique in ACL reconstruction in nonprofessional athletes.
目的
在前交叉韧带（ACL）重建中，股骨隧道的两种钻孔技术常用：经胫骨（TT）入路或经前内侧（AM）入路。本研究的目的是调查在非职业运动员中使用AM和TT入路技术钻股骨隧道的关节镜下单束ACL重建的影像学和临床结果。
方法
回顾性分析2011年至2013年间44例接受AM和TT技术进行ACL重建的非职业运动员。测量轴向磁共振成像（MRI）上股骨隧道的钟面位置以及矢状面MRI扫描上胫骨隧道的前后位置。评估影像学上股骨隧道和胫骨隧道的前后倾斜角度。在末次随访时，使用Lachman试验和轴移试验评估膝关节的前后稳定性和膝关节的旋转稳定性。对于临床和功能评估，使用改良的辛辛那提膝关节评分系统、Lysholm膝关节评分量表和国际膝关节文献委员会（IKDC）表格。
结果
两组在患者年龄、随访时间、性别和患侧分布方面无统计学显著差异。TT组因钟面位置有6例异常值。AM组股骨隧道平均倾斜角度为31.07°±8.44°，TT组为19.02°±8.93°。TT组胫骨隧道倾斜角度为21.08°±5.42°，AM组为16.58°±7.02°。两组间有统计学显著差异。两组在Lachman试验、轴移试验、Lysholm评分、IKDC评分和改良辛辛那提评分结果方面无统计学显著差异。
结论
在非职业运动员的ACL重建中，AM技术与TT技术相比无临床优势。
Zotero 插件