Department of Orthopaedic Surgery, Kamimoku Spa Hospital, Minakami, Japan.
Knee Surg Sports Traumatol Arthrosc. 2022 Oct;30(10):3322-3327. doi: 10.1007/s00167-022-06921-8. Epub 2022 Feb 24.
The purpose of this study was to investigate the correlation between femoral intercondylar notch volume and the characteristics of femoral tunnels in anatomical single bundle anterior cruciate ligament (ACL) reconstruction.
Fifty-one subjects (24 male and 27 female: median age 27: range 15-49), were included in this study. Anatomical single bundle ACL reconstruction was performed in all subjects using a trans-portal technique. Femoral tunnel length was measured intra-operatively. Three-dimensional computed tomography (3D-CT) was taken at pre and post-surgery. The intercondylar notch volume was calculated with a truncated-pyramid shape simulation using the pre-operative 3D-CT image. In the post-operative 3D-CT, the modified quadrant method was used to measure femoral ACL tunnel placement.
Femoral tunnel placement was 47.6 ± 10.5% in the high-low (proximal-distal) direction, and 22.6 ± 5.4% in the shallow-deep (anterior-posterior) direction. Femoral tunnel length was 35.3 ± 4.4 cm. Femoral intercondylar notch volume was 8.6 ± 2.1cm. A significant correlation was found between femoral intercondylar notch volume and high-low (proximal-distal) femoral tunnel placement (Pearson's coefficient correlation: 0.469, p = 0.003).
Femoral ACL tunnel placement at a significantly lower level was found in knees with large femoral intercondylar notch volume in the trans-portal technique. For the clinical relevance, although the sample size of this study was limited, surgeons can create femoral ACL tunnel low (distal) in the notch where close to the anatomical ACL footprint in the knees with large femoral intercondylar notch volume.
III.
本研究旨在探讨股骨髁间切迹容积与解剖学单束前交叉韧带（ACL）重建中股骨隧道特征的相关性。
本研究纳入了 51 名受试者（24 名男性和 27 名女性；中位数年龄 27 岁：范围 15-49 岁）。所有受试者均采用经皮隧道技术行解剖学单束 ACL 重建。术中测量股骨隧道长度。术前和术后均行三维 CT（3D-CT）检查。利用术前 3D-CT 图像，采用截顶金字塔形状模拟法计算髁间切迹容积。术后 3D-CT 采用改良象限法测量股骨 ACL 隧道位置。
股骨隧道在高-低（近-远）方向上的位置为 47.6±10.5%，在浅-深（前-后）方向上的位置为 22.6±5.4%。股骨隧道长度为 35.3±4.4cm。股骨髁间切迹容积为 8.6±2.1cm。股骨髁间切迹容积与高-低（近-远）股骨隧道位置之间存在显著相关性（Pearson 系数相关性：0.469，p=0.003）。
在经皮隧道技术中，髁间切迹容积较大的膝关节股骨 ACL 隧道位置较低（远侧）。就临床相关性而言，尽管本研究的样本量有限，但对于髁间切迹容积较大的膝关节，外科医生可以在接近解剖学 ACL 足印的位置在切迹处创建股骨 ACL 隧道低位（远侧）。
III 级。
