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改良经胫骨与前内侧入路技术在解剖单束前交叉韧带重建中的比较

Comparison of Modified Transtibial and Anteromedial Portal Techniques in Anatomic Single-Bundle ACL Reconstruction.

作者信息

Han Joung Kyue, Chun Keun Churl, Lee Seong In, Kim Saintpee, Chun Churl Hong

出版信息

Orthopedics. 2019 Mar 1;42(2):83-89. doi: 10.3928/01477447-20190211-04. Epub 2019 Feb 14.

DOI:10.3928/01477447-20190211-04
PMID:30763445
Abstract

The purpose of this study was to compare the clinical, 3-dimensional computed tomography, magnetic resonance imaging, and second-look arthroscopic findings of the modified transtibial technique with those of the anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction (SB-ACLR). Among patients who underwent SB-ACLR from February 2012 to May 2014, 95 patients with a minimum of 36 months of follow-up were included in this retrospective study. Forty-five patients underwent a reconstruction using the modified transtibial technique. Fifty patients underwent a reconstruction using the anteromedial portal technique. Clinical scores and stabilities were recorded preoperatively and at final follow-up. All patients had postoperative computed tomography and the computed tomography parameters, including tunnel position and graft obliquity, evaluated. Additionally, postoperative magnetic resonance imaging and second-look arthroscopy were performed. On the basis of the functional and stability outcomes, all of the patients showed significant improvement after SB-ACLR, with no significant differences existing between the 2 groups (P>.05). Tunnel position and obliquity were not significantly different between the 2 groups (P>.05). There were no statistically significant differences between the 2 groups regarding the magnetic resonance imaging and second-look arthroscopy findings (P>.05). The tunnel characteristics and clinical results of the 2 techniques were comparable. Given the several advantages of the modified transtibial technique, including its simplicity and patients' greater activity level, it is suitable for anatomic SB-ACLR. [Orthopedics. 2019; 42(2):83-89.].

摘要

本研究旨在比较改良经胫骨技术与前内侧入路技术在单束前交叉韧带重建(SB-ACLR)中的临床、三维计算机断层扫描、磁共振成像及二次关节镜检查结果。在2012年2月至2014年5月接受SB-ACLR的患者中,95例至少随访36个月的患者纳入本回顾性研究。45例患者采用改良经胫骨技术进行重建。50例患者采用前内侧入路技术进行重建。术前及末次随访时记录临床评分和稳定性。所有患者均进行术后计算机断层扫描,并评估计算机断层扫描参数,包括隧道位置和移植物倾斜度。此外,还进行了术后磁共振成像和二次关节镜检查。基于功能和稳定性结果,所有患者在SB-ACLR后均有显著改善,两组之间无显著差异(P>0.05)。两组之间的隧道位置和倾斜度无显著差异(P>0.05)。两组在磁共振成像和二次关节镜检查结果方面无统计学显著差异(P>0.05)。两种技术的隧道特征和临床结果具有可比性。鉴于改良经胫骨技术的诸多优点,包括其操作简单和患者活动水平较高,它适用于解剖学SB-ACLR。[《骨科》。2019年;42(2):83-89。]

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