Vadlamudi Abhinay, Kale Amit, Sharma Jaiman, Patil Vishal, Pai Mukund
Orthopedic Surgery, Dr. D. Y. Patil Medical college, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Cureus. 2022 Mar 21;14(3):e23367. doi: 10.7759/cureus.23367. eCollection 2022 Mar.
Introduction Anterior cruciate ligament (ACL) reconstruction techniques continue to evolve and the need to address the more anatomical femoral tunnel placement of the graft is critical, and in our study, we assessed the placement of femoral tunnel via transportal and retrograde drilling techniques. Material and methods Sixty patients where n=31 for retrograde, n=29 for transportal were assessed via CT knee for the femoral tunnel aperture on the intercondylar ridge via high low and deep shallow direction ratio and interpreted accordingly. Results In our study, the femoral tunnel done via transportal method (n=29) has a deep shallow ratio range of 22%-47% and mean of 31.9±6.5, and graft is anatomical in 79%. The femoral tunnel done via the retrograde method (n=31) has a deep shallow depth ratio range of 11%-41% with a mean of 27.5±6.5 and graft is anatomical in 77% of the study group and the p-value means the ratio is 0.01 (significant). The femoral tunnel done via transportal method (n=29) has a high low ratio range of 19%-45% and mean of 32.9±6.3 and graft is anatomical in 72%. The femoral tunnel done via the retrograde method (n=31) has a deep shallow depth ratio range of 20%-38% with a mean of 33.9±4.1 and graft is anatomical in 94% of the study group with a p-value mean ratio being 0.51 (insignificant). Conclusion Watch out for the femoral tunnel placement in a deep shallow direction while going for standard transportal technique and high low direction while performing retrograde technique.
引言 前交叉韧带（ACL）重建技术不断发展，解决移植物更符合解剖结构的股骨隧道放置问题至关重要。在我们的研究中，我们通过经胫骨隧道和逆行钻孔技术评估了股骨隧道的放置情况。
材料与方法 60例患者，其中逆行钻孔组n = 31例，经胫骨隧道组n = 29例，通过膝关节CT评估髁间嵴上股骨隧道开口的高低和深浅方向比例，并据此进行解读。
结果 在我们的研究中，经胫骨隧道法（n = 29）制作的股骨隧道深浅比例范围为22% - 47%，平均为31.9±6.5，79%的移植物符合解剖结构。逆行法（n = 31）制作的股骨隧道深浅比例范围为11% - 41%，平均为27.5±6.5，77%的研究组移植物符合解剖结构，p值表明该比例为0.01（具有显著性）。经胫骨隧道法（n = 29）制作的股骨隧道高低比例范围为19% - 45%，平均为32.9±6.3，72%的移植物符合解剖结构。逆行法（n = 31）制作的股骨隧道深浅比例范围为20% - 38%，平均为33.9±4.1，94%的研究组移植物符合解剖结构，p值平均比例为0.51（无显著性）。
结论 在采用标准经胫骨隧道技术时，要注意股骨隧道在深浅方向的放置；在进行逆行技术时，要注意高低方向。
