Yu Han, Huang Cheng-Long, Chen Jia-Yi, Kong Xiang-Jia, Ren Peng, Xu Hong-Wei, Song Dan-Dan, Chen Gang
Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing College, Jiaxing 314000, Zhejing, China.
Zhongguo Gu Shang. 2021 Dec 25;34(12):1126-31. doi: 10.12200/j.issn.1003-0034.2021.12.007.
To compare the femoral and tibial tunnel positions of anterior cruciate ligament reconstruction using the modified transtibial (MTT) technique and anteromedial (AM) portal technique.
Between January 2017 and September 2020, 78 patients with anterior cruciate ligament rupture underwent single-bundle reconstruction with the modified transtibial technique in 39 cases (group MTT) and through anteromedial approach in 39 cases (group AM). There were 25 males and 14 females in group MTT, with an average age of (37.0±2.3) years old; 27 males and 12 females in group AM, with an average age of (37.5±2.2) years old. CT scan of the affected knee was conducted one week after the surgery to measure and compare the femoral tunnels positioning (Fx, Fy), tibial tunnels positioning in the frontal plane(Tx1), tibial tunnels positioning in the sagittal plane (Ty1), and tibial tunnels positioning in the axial plane (Tx2, Ty2) in patients undergoing anterior cruciate ligament reconstruction through Mimics software.
Three-dimensional CT reconstruction after the surgery showed that the average Fx and Fy were(25.2±2.1)% and (34.9±3.0)% respectively and the Tx1 and Ty1 were (45.5±3.3)% and (44.7± 3.0)% respectively, while the Tx2 and Ty2 were (47.0±3.0)% and (39.9±4.2)% respectively in group MTT. In group AM, the average Fx and Fy were (26.0±2.0)% and (36.1±3.9)% respectively and the Tx1 and Ty1 were (46.5±3.1)% and (45.6± 3.1)% respectively, while the Tx2 and Ty2 were (47.4±2.5)% and (39.6±3.9)% respectively. There were no statistically significant differences in the femoral and tibial tunnels between the two groups (>0.05). Patients in both two groups obtained anatomic anterior cruciate ligament reconstruction.
Both the MTT and AM technique can achieve good anatomical positioning of the femoral and tibial tunnels, without significant differences in the positioning of the bone tunnels.
比较采用改良经胫骨（MTT）技术和前内侧（AM）入路技术进行前交叉韧带重建时股骨和胫骨隧道的位置。
2017年1月至2020年9月，78例前交叉韧带断裂患者接受单束重建，其中39例采用改良经胫骨技术（MTT组），39例采用前内侧入路（AM组）。MTT组男25例，女14例，平均年龄（37.0±2.3）岁；AM组男27例，女12例，平均年龄（37.5±2.2）岁。术后1周对患膝进行CT扫描，通过Mimics软件测量并比较前交叉韧带重建患者的股骨隧道定位（Fx、Fy）、冠状面胫骨隧道定位（Tx1）、矢状面胫骨隧道定位（Ty1）以及横断面胫骨隧道定位（Tx2、Ty2）。
术后三维CT重建显示，MTT组平均Fx和Fy分别为（25.2±2.1）%和（34.9±3.0）%，Tx1和Ty1分别为（45.5±3.3）%和（44.7±3.0）%，Tx2和Ty2分别为（47.0±3.0）%和（39.9±4.2）%。AM组平均Fx和Fy分别为（26.0±2.0）%和（36.1±3.9）%，Tx1和Ty1分别为（46.5±3.1）%和（45.6±3.1）%，Tx2和Ty2分别为（47.4±2.5）%和（39.6±3.9）%。两组股骨和胫骨隧道差异无统计学意义（>0.05）。两组患者均实现了前交叉韧带的解剖重建。
MTT技术和AM技术均可实现股骨和胫骨隧道良好的解剖定位，骨隧道定位差异无统计学意义。
