Department of Orthopaedic Surgery, Graduate School of Medical Science Kanazawa UniversityKanazawa, Japan.
J Orthop Surg (Hong Kong). 2021 Sep-Dec;29(3):23094990211061249. doi: 10.1177/23094990211061249.
We have previously described anterior cruciate ligament reconstruction with a rounded rectangular femoral tunnel created using a rounded rectangular dilator designed to enable a more anatomical and wider tendon-bone junction. However, the influence of remnant tissue preservation on the creation of the rounded rectangular femoral tunnel is not clear. This study aimed to evaluate the influence of remnant tissue preservation on the creation of the rounded rectangular femoral tunnel.
A total of 198 patients who underwent primary anterior cruciate ligament reconstruction with a rounded rectangular femoral tunnel were evaluated retrospectively. Patients were categorized into a remnant preservation group (group P) and a non-preservation group (group N). Computed tomography images taken 1 week postoperatively were analyzed. The location of the rounded rectangular femoral tunnel evaluated using the quadrant method, its rotation angle, and the graft bending angle were compared between the two groups. The differences and the variance in femoral tunnel assessment were compared using the two-sample t-test and Levene's test.
Although there was no significant difference in the location of femoral tunnel for the deep/shallow direction along the Blumensaat's line (difference, = .326; variances, = .970), the tunnel was significantly lower in group P than in group N, with no variances (difference, = .001; variances, = .326). There were no significant differences and no variances in the tunnel rotation angle and the graft bending angle (difference, = .727 and 0.514, respectively; variances, = .827 and .445, respectively). Blow out of the posterior wall of the medial aspect of the femoral lateral condyle was an intraoperative complication that occurred in one case in group N.
The remnant preservation approach creates a lower femoral tunnel compared to the non-preservation technique. However, a rounded rectangular femoral tunnel can be created safely and is reproducible with remnant tissue preservation.
我们之前描述了使用设计成能够实现更解剖学和更宽的肌腱-骨结合的矩形扩孔器创建的前交叉韧带重建中的股骨隧道的矩形化。然而，保留残余组织对创建矩形股骨隧道的影响尚不清楚。本研究旨在评估保留残余组织对创建矩形股骨隧道的影响。
回顾性分析了 198 例采用矩形股骨隧道行初次前交叉韧带重建的患者。患者分为保留残余组织组（组 P）和不保留残余组织组（组 N）。对术后 1 周的 CT 图像进行分析。使用象限法评估矩形股骨隧道的位置、旋转角度和移植物弯曲角度，并比较两组之间的差异。使用两样本 t 检验和 Levene 检验比较股骨隧道评估的差异和方差。
尽管在 Blumensaat 线的深浅方向上，股骨隧道的位置没有显著差异（差异 =.326；方差 =.970），但组 P 中的隧道明显低于组 N，且无方差（差异 =.001；方差 =.326）。隧道旋转角度和移植物弯曲角度无显著差异和方差（差异分别为 =.727 和 0.514，方差分别为 =.827 和.445）。组 N 中有 1 例发生内侧股骨外侧髁后壁爆裂的术中并发症。
与不保留残余组织技术相比，保留残余组织技术会创建一个较低的股骨隧道。然而，在保留残余组织的情况下，可以安全地创建矩形股骨隧道，并且具有可重复性。
