Dong Yi-Long, Cai Chun-Yuan, Jiang Gang-Yi, Qian Yue-Nan, Yang Guo-Jing
Technol Health Care. 2017 Aug 9;25(4):729-737. doi: 10.3233/THC-160414.
We studied the anatomic positioning of the femoral tunnel during simulated anterior cruciate ligament reconstruction using an anteromedial portal approach in cadaveric models.
In thirty cadaveric human knee specimens, simulation of an arthroscopic anterior cruciate ligament reconstruction was performed and the femoral tunnel was drilled using an anteromedial portal. A Kirschner wire was passed into the tunnel and radiographs were obtained. These radiographs were then evaluated in the coronal and sagittal planes. Angles between the axis of the femoral tunnel and the joint line in the coronal plane (alpha, α) or the femoral long axis in the sagittal plane (beta, β) were calculated for each specimen. The external aperture of the femoral tunnel was defined as the point of exit of the Kirschner wire from the lateral femoral cortex. This was evaluated relative to a prescribed rectangle and coordinate axis, with the radiographic quadrant method of Bernard, to assess the accuracy of femoral tunnel placement.
The mean α in the coronal plane was 48.53∘, the mean β in the sagittal plane was 32.23∘. All of the femoral tunnel external apertures were located outside of the rectangleCONCLUSION: We evaluated the positioning of the femoral tunnel and the external aperture of the femoral tunnel with the anteromedial portal technique. This study provides a reference standard to assess accurately femoral tunnel positioning on postoperative radiographs.
我们在尸体模型中使用前内侧入路模拟前交叉韧带重建过程，研究了股骨隧道的解剖定位。
在30个尸体人膝关节标本上，进行关节镜下前交叉韧带重建模拟，并使用前内侧入路钻入股骨隧道。将一根克氏针插入隧道并拍摄X线片。然后在冠状面和矢状面评估这些X线片。计算每个标本股骨隧道轴线与冠状面关节线之间的角度（α角）或矢状面股骨长轴之间的角度（β角）。股骨隧道的外口定义为克氏针从股骨外侧皮质穿出的点。使用伯纳德射线照相象限法，相对于规定的矩形和坐标轴对其进行评估，以评估股骨隧道放置的准确性。
冠状面平均α角为48.53°，矢状面平均β角为32.23°。所有股骨隧道外口均位于矩形之外。
我们使用前内侧入路技术评估了股骨隧道的定位以及股骨隧道的外口。本研究为术后X线片上准确评估股骨隧道定位提供了参考标准。
