Kim Jun-Ho, Kim Hoon-Young, Lee Dae-Hee
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Int Orthop. 2018 Sep;42(9):2097-2103. doi: 10.1007/s00264-018-3954-3. Epub 2018 Apr 26.
Placement of the femoral tunnel is critical to graft function after posterior cruciate ligament (PCL) reconstruction. To date, however, the location of the femoral tunnel aperture has not been compared by in vivo 3-dimensional computed tomography (3D-CT) during PCL reconstruction with the outside-in (OI) and inside-out (IO) techniques. This study used 3D-CT analysis to compare the location of the femoral tunnel aperture in patients who underwent PCL reconstruction with the OI and IO techniques.
A total of 77 patients underwent single-bundle PCL reconstruction using the OI (n = 46) or IO (n = 31) technique. The location of the femoral tunnel aperture was assessed by 3D-CT and measured by the anatomic coordinate axis method to construct 3D surface models.
The mean location of the femoral tunnel aperture in the low-to-high direction did not differ significantly in the OI and IO groups (75.0 vs. 75.2%, P = 0.869). However, in the deep-to-shallow direction, the femoral tunnel aperture was positioned more shallowly in the IO than in the OI group (75.7 vs. 81.1%, P < 0.001).
The IO technique of single-bundle PCL reconstruction yielded a shallower femoral tunnel in the deep-to-shallow direction than did the OI technique. However, femoral tunnel location in the low-to-high direction was similar using the two techniques.
在后交叉韧带（PCL）重建术后，股骨隧道的定位对移植物功能至关重要。然而，迄今为止，在PCL重建术中，尚未通过体内三维计算机断层扫描（3D-CT）对采用由外向内（OI）和由内向外（IO）技术时股骨隧道开口的位置进行比较。本研究采用3D-CT分析，比较采用OI和IO技术进行PCL重建的患者股骨隧道开口的位置。
共有77例患者采用OI技术（n = 46）或IO技术（n = 31）进行单束PCL重建。通过3D-CT评估股骨隧道开口的位置，并采用解剖坐标轴法进行测量以构建3D表面模型。
在低到高方向上，OI组和IO组股骨隧道开口的平均位置无显著差异（75.0%对75.2%，P = 0.869）。然而，在深到浅方向上，IO组的股骨隧道开口位置比OI组更浅（75.7%对81.1%，P < 0.001）。
单束PCL重建的IO技术在深到浅方向上产生的股骨隧道比OI技术更浅。然而，两种技术在低到高方向上的股骨隧道位置相似。
