Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Knee. 2021 Mar;29:298-304. doi: 10.1016/j.knee.2021.02.020. Epub 2021 Mar 5.
The purpose of this study was to investigate the influence of a selected plane on the evaluation of tibial tunnel locations following anterior cruciate ligament reconstruction (ACLR) between two planes: the plane parallel to the tibial plateau (Plane A) and the plane perpendicular to the proximal tibial shaft axis (Plane B).
Thirty-four patients who underwent double-bundle ACLR were included. Three-dimensional model of tibia was created using computed tomography images 2 weeks postoperatively, and tibial tunnels of the anteromedial bundle (AMB) and posterolateral bundle (PLB) were extracted. To evaluate tibial tunnel locations, two planes (Planes A and B) were created. The locations of the tibial tunnel apertures of each bundle were evaluated using a grid method and compared between Planes A and B. The difference in coronal alignment between Planes A and B were also assessed.
The AMB and PLB tunnel apertures in Plane A were significantly more laterally located than in Plane B (mean difference; AMB, 1.5%; PLB, 1.7%, P < 0.01). There were no significant differences in the anteroposterior direction between the planes. Coronal alignment difference between the planes was 16.8 ± 2.2°; Plane B was more valgus than Plane A.
Although tibial tunnel locations were not significantly influenced by the selected planes in the AP direction, subtle but statistically significant differences were found in the ML direction between the Planes A and B in double-bundle anterior cruciate ligament reconstruction. The findings suggest that both Planes A and B can be used in the assessment of tibial tunnel locations after anterior cruciate ligament reconstruction.
本研究旨在探讨在两种平面（平行于胫骨平台的平面 A 和垂直于胫骨近端骨干轴的平面 B）之间，对前交叉韧带重建（ACL）后胫骨隧道位置的评估，研究选定平面的影响。
纳入 34 例接受双束 ACLR 的患者。术后 2 周使用 CT 图像创建胫骨三维模型，并提取前内侧束（AMB）和后外侧束（PLB）的胫骨隧道。为了评估胫骨隧道位置，创建了两个平面（A 平面和 B 平面）。使用网格法评估每个束的胫骨隧道开口位置，并比较 A 平面和 B 平面之间的差异。还评估了 A 平面和 B 平面之间冠状面排列的差异。
AMB 和 PLB 隧道开口在 A 平面上明显更偏向外侧，与 B 平面相比差异有统计学意义（平均差异；AMB，1.5%；PLB，1.7%，P<0.01）。在前后方向上，两个平面之间没有显著差异。平面之间的冠状面排列差异为 16.8±2.2°；B 平面比 A 平面更外翻。
尽管在 AP 方向上，胫骨隧道位置不受所选平面的显著影响，但在双束前交叉韧带重建中，A 平面和 B 平面之间在 ML 方向上存在微小但具有统计学意义的差异。这些发现表明，A 平面和 B 平面均可用于评估前交叉韧带重建后的胫骨隧道位置。
