Kim Dong Hwi, Lim Won-Bong, Cho Sung-Won, Lim Chae-Won, Jo Suenghwan
Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Republic of Korea.
Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Republic of Korea.
Arthroscopy. 2016 Aug;32(8):1660-6. doi: 10.1016/j.arthro.2016.01.043. Epub 2016 Apr 16.
To validate whether the Bernard quadrant method, which was developed for application on simple lateral radiography, can be used with 3-dimensional computed tomography (3D CT) to localize the femoral insertion of the reconstructed anterior cruciate ligament (ACL).
We analyzed 32 knees with ACL tears that were reconstructed using a metal interference screw for fixation at the femoral tunnel between March 2012 and May 2013. Postoperative lateral radiographs and 3D CT images were obtained 7 days after the operation. By use of the Bernard quadrant method, the location of the femoral tunnel was measured by 2 orthopaedic surgeons by locating the position of the metal interference screw using 3D CT imaging and simple lateral knee radiography. The correlation between the femoral tunnels on the 2 radiographic images was compared using the MedCalc statistical analysis program.
On the 3D CT image, the position of the femoral insertion of the ACL as measured by the position of the metal screw head was 36.3% ± 6.0% in the x-coordinate and 39.6% ± 9.1% in the y-coordinate compared with 37.6% ± 5.8% and 41.0% ± 11.6%, respectively, on the simple radiograph. The Pearson correlation coefficients between 3D CT and simple radiography were 0.840 for the x-coordinate and 0.858 for the y-coordinate. Intraobserver reliability and interobserver reliability for both coordinates were greater than 0.9 on 3D CT.
Application of the Bernard quadrant method on 3D CT showed high correlation to the originally described method using lateral radiographs and can be used reliably for localizing the reconstructed ACL.
Level III, diagnostic study.
验证为应用于简单的侧位X线片而开发的伯纳德象限法是否可用于三维计算机断层扫描（3D CT）以定位重建前交叉韧带（ACL）的股骨止点。
我们分析了2012年3月至2013年5月间32例ACL撕裂且使用金属干涉螺钉固定于股骨隧道进行重建的膝关节。术后7天获得术后侧位X线片和3D CT图像。通过使用伯纳德象限法，由2名骨科医生通过3D CT成像和简单的膝关节侧位X线片定位金属干涉螺钉的位置来测量股骨隧道的位置。使用MedCalc统计分析程序比较两张X线片上股骨隧道之间的相关性。
在3D CT图像上，通过金属螺钉头部位置测量的ACL股骨止点位置在x坐标上为36.3%±6.0%，在y坐标上为39.6%±9.1%，而在简单X线片上分别为37.6%±5.8%和41.0%±11.6%。3D CT与简单X线片之间x坐标的Pearson相关系数为0.840，y坐标为0.858。在3D CT上，两个坐标的观察者内可靠性和观察者间可靠性均大于0.9。
伯纳德象限法在3D CT上的应用与最初描述的使用侧位X线片的方法具有高度相关性，并且可以可靠地用于定位重建的ACL。
III级，诊断性研究。
