Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan, China.
National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Knee Surg Sports Traumatol Arthrosc. 2023 Jan;31(1):219-228. doi: 10.1007/s00167-022-07084-2. Epub 2022 Aug 10.
This study aimed to comparatively evaluate the accuracy of femoral tunnel positioning after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction performed with the remnant preservation (RP) technique versus the non-remnant preservation (NRP) technique.
A retrospective review of 145 patients who underwent ACL reconstruction from May 2020 to May 2022 were performed in this single-surgeon study. A total of 120 patients met the inclusion criteria and were allocated into two groups according to the surgical technique (i.e. RP group and NRP group). The relative location of the femoral tunnel in the lateral condyle was evaluated as a percentage using a standardized grid system on the three-dimensional computed tomography (3D-CT) image. The accuracy and precision of the RP group were assessed based on published anatomical data in direct comparison with the NRP group.
According to the surgical procedure, 57 of the 120 patients included were allocated into the RP group, and 63 into the NRP group. Significant differences were observed between the two groups in terms of tunnel position (posterior-to-distal (PD): 28.4 ± 5.4% (RP) vs. 31.8 ± 5.3% (NRP); P = 0.01), (anterior-to-posterior (AP): 32.6 ± 7.7% (RP) vs. 38.8 ± 7.7% (NRP); P = 0.00), while no significant differences were found in terms of the accuracy (8.6% (RP) vs. 8.9% (NRP); n.s) and precision (4.4% (RP) vs. 5.6% (NRP); n.s) of femoral tunnel positioning between the two groups.
From this single-surgeon study, it was concluded that there were no differences in the creation of ACL femoral tunnel between the RP technique and the non-remnant preserving technique. Meanwhile, the RP technique would not sacrifice the ideal position of the femoral tunnel and is able to retain the possible benefits of the ACL stump.
Level III.
本研究旨在比较分析解剖单束前交叉韧带（ACL）重建中采用残端保留（RP）技术与非残端保留（NRP）技术时股骨隧道定位的准确性。
本研究为单外科医生回顾性研究，纳入了 2020 年 5 月至 2022 年 5 月期间行 ACL 重建的 145 例患者。共有 120 例患者符合纳入标准，并根据手术技术分为两组（即 RP 组和 NRP 组）。通过三维 CT（3D-CT）图像上的标准化网格系统，以百分比的形式评估股骨隧道在外侧髁上的相对位置。根据已发表的解剖学数据，与 NRP 组进行直接比较，评估 RP 组的准确性和精密度。
根据手术过程，120 例患者中 57 例被分配至 RP 组，63 例被分配至 NRP 组。两组在隧道位置方面存在显著差异（后-远端（PD）：28.4±5.4%（RP）比 31.8±5.3%（NRP）；P=0.01），（前-后（AP）：32.6±7.7%（RP）比 38.8±7.7%（NRP）；P=0.00），而在股骨隧道定位的准确性（8.6%（RP）比 8.9%（NRP）；n.s）和精密度（4.4%（RP）比 5.6%（NRP）；n.s）方面无显著差异。
本单外科医生研究结果表明，RP 技术与非残端保留技术在 ACL 股骨隧道的建立方面无差异。同时，RP 技术不会牺牲股骨隧道的理想位置，并能够保留 ACL 残端的可能获益。
III 级。
