Prejbeanu Radu, Mioc Mihail Lazar, Jebelean Silviu, Balanescu Andrei, Feier Andrei-Marian, Pop Tudor Sorin, Russu Octav
Department of Orthopedics, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Department of Orthopedics and Traumatology, Premiere Hospital Timisoara, 300643 Timisoara, Romania.
J Clin Med. 2023 Aug 21;12(16):5426. doi: 10.3390/jcm12165426.
The identification of the branch of the inferior medial genicular artery (bIMGA) in anterior cruciate ligament reconstructions (ACLRs) has previously been considered a landmark by some surgeons, but its consistency remains debated. The aim of this investigation was to evaluate the variability in the appearance and location of bIMGA and to assess its validity as a reliable landmark during hamstring tendon harvesting procedures.
This prospective, single-center study comprised 213 patients who underwent ACLR over a period of two years. The surgical procedures were conducted by the same surgical team, maintaining uniformity in the approach. The study sought correlations between patient demographics, level of activity, and the potential for successful identification of the bIMGA.
A statistically significant association between patient activity levels and successful identification of the bIMGA ( = 0.035) was observed. No significant correlations were found concerning patient demographic characteristics. bIMGA demonstrated a substantial degree of anatomical variability, rendering its consistent identification in the surgical field challenging.
Given the observed variability and the associated difficulty in its identification, the use of the bIMGA as a dependable anatomical reference during ACL graft harvesting is not recommended. This study confirms the inconsistency of bIMGA as a traditional landmark, underscoring the need for research aimed at identifying more consistent and reliable anatomical references to enhance the precision of surgical interventions in ACLR.
在一些外科医生看来，在前交叉韧带重建术（ACLR）中识别膝下内侧动脉分支（bIMGA）曾被视为一个标志，但它的一致性仍存在争议。本研究的目的是评估bIMGA外观和位置的变异性，并评估其在腘绳肌腱取材过程中作为可靠标志的有效性。
这项前瞻性单中心研究纳入了213例在两年内接受ACLR的患者。手术由同一手术团队进行，保持手术入路的一致性。该研究探寻了患者人口统计学特征、活动水平与成功识别bIMGA可能性之间的相关性。
观察到患者活动水平与成功识别bIMGA之间存在统计学显著关联（P = 0.035）。未发现与患者人口统计学特征相关的显著相关性。bIMGA表现出很大程度的解剖变异性，使其在手术视野中持续被识别具有挑战性。
鉴于观察到的变异性以及识别它的相关困难，不建议在ACL移植物取材期间将bIMGA用作可靠的解剖学参考。本研究证实了bIMGA作为传统标志的不一致性，强调需要开展旨在识别更一致、更可靠解剖学参考的研究，以提高ACLR手术干预的精确性。
