Hiranaka Takaaki, Furumatsu Takayuki, Okazaki Yuki, Kintaka Keisuke, Higashihara Naohiro, Tamura Masanori, Nakata Eiji, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
Department of Orthopaedic Surgery, Ako Central Hospital, 52‑6 Sohmon‑cho, Ako, Hyogo 678‑0241, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Apr 6;32:1-6. doi: 10.1016/j.asmart.2023.03.001. eCollection 2023 Apr.
BACKGROUND/OBJECTIVE: Accurate tibial tunnel creation is crucial for successful transtibial pullout repair of medial meniscus (MM) posterior root tears (MMPRTs). This study aimed to evaluate the accuracy of the newly developed Zimmer Biomet Root Aiming (ZeBRA) guide for transtibial pullout repair of MMPRTs.
This study included 50 patients who underwent transtibial pullout repair using the Unicorn Meniscal Root (UMR) (n = 25) and ZeBRA (n = 25) guides. The expected anatomic centre (AC) and tibial tunnel centre (TC) were assessed using three-dimensional postoperative computed tomography (CT) images. The expected AC was defined as the centre of the circle tangent to the triangular footprint of the MM posterior root. The expected AC and TC on the tibial surface were assessed using the percentage-based posterolateral location on the tibial surface. The absolute distance between the AC and TC (mm) was evaluated.
The mean AC location was 76.1% ± 3.1% posterior and 40.8% ± 2.1% lateral, whereas the mean TC location was 76.7% ± 5.3% posterior and 37.2% ± 3.6% lateral using the UMR guide and 75.8% ± 3.1% posterior and 36.5% ± 2.4% lateral using the ZeBRA guide. No significant difference was observed in the absolute distance between the UMR and ZeBRA guides (3.9 ± 1.4 and 3.8 ± 1.3 mm, respectively; p = 0.617).
The newly developed ZeBRA guide allows accurate tibial tunnel creation, and its accuracy is comparable to that of the conventional UMR guide. Tibial tunnels were created at optimal positions using both guides, and the choice of the guide would depend on the surgeon's preference.
背景/目的：准确创建胫骨隧道对于内侧半月板（MM）后根部撕裂（MMPRT）的经胫骨拉出修复成功至关重要。本研究旨在评估新开发的齐默·生物梅德根瞄准（ZeBRA）导向器用于MMPRT经胫骨拉出修复的准确性。
本研究纳入50例行经胫骨拉出修复的患者，其中25例使用独角兽半月板根部（UMR）导向器，25例使用ZeBRA导向器。使用术后三维计算机断层扫描（CT）图像评估预期解剖中心（AC）和胫骨隧道中心（TC）。预期AC定义为与MM后根三角形足迹相切的圆的中心。使用基于百分比的胫骨表面后外侧位置评估胫骨表面的预期AC和TC。评估AC和TC之间的绝对距离（毫米）。
使用UMR导向器时，平均AC位置为后76.1%±3.1%，外侧40.8%±2.1%；使用ZeBRA导向器时，平均TC位置为后76.7%±5.3%，外侧37.2%±3.6%；使用ZeBRA导向器时，平均AC位置为后75.8%±3.1%，外侧36.5%±2.4%。UMR和ZeBRA导向器之间的绝对距离无显著差异（分别为3.9±1.4和3.8±1.3毫米；p = 0.617）。
新开发的ZeBRA导向器可实现准确的胫骨隧道创建，其准确性与传统UMR导向器相当。两种导向器均能在最佳位置创建胫骨隧道，导向器的选择将取决于外科医生的偏好。
