Yücel Mücahid Osman, Dalaslan Raşit Emin, Sağlam Sönmez, Karaduman Zekeriya Okan, Arıcan Mehmet, Akar Bedrettin, Tural Volkan
Department of Orthopaedics and Traumatology, Faculty of Medicine, Duzce University, 81620 Duzce, Türkiye.
Department of Orthopedics and Traumatology, Sakarya Yenikent State Hospital, 54290 Sakarya, Türkiye.
Diagnostics (Basel). 2025 May 14;15(10):1237. doi: 10.3390/diagnostics15101237.
: The correct angular placement of the tibial tunnel is crucial to ensure graft tension, maintain knee stability, and ensure optimal clinical outcomes after anterior cruciate ligament (ACL) reconstruction. While 3D imaging methods such as MRI and CT are the gold standard for evaluating tunnel positioning, their routine use is limited by cost, availability, and time constraints. In clinical practice, 2D radiographs are more accessible but lack established reliability in accurately estimating tunnel angles. The aim of this study was to convert 2D radiographic angular measurements used in the evaluation of patients undergoing anterior cruciate ligament reconstruction into 3D values with a simple method and to compare these measurements with three-dimensional angles calculated using conventional MRI and CT. : This retrospective study included 38 patients who underwent anatomic anterior cruciate ligament reconstruction. Postoperative radiographs and MR images were analyzed to determine the tibial tunnel angles. The angles calculated from 2D radiographs were statistically analyzed for their correlation with the actual 3D angles measured by MRI. : The analysis showed a strong correlation between tibial tunnel angles from radiographs and MRI, with minimal, non-significant differences. This suggests that radiographs can provide a reliable estimate of tibial tunnel angles. : These findings suggest that radiographs can predict tibial tunnel angles in ACL reconstruction as accurately as MRI. This method can guide the correct tunnel angle and facilitate postoperative evaluation. Further studies are needed to confirm these results across various populations and techniques.
胫骨隧道的正确角度定位对于确保移植物张力、维持膝关节稳定性以及确保前交叉韧带（ACL）重建术后的最佳临床效果至关重要。虽然诸如MRI和CT等3D成像方法是评估隧道位置的金标准，但它们的常规使用受到成本、可用性和时间限制。在临床实践中，2D X光片更容易获取，但在准确估计隧道角度方面缺乏既定的可靠性。本研究的目的是用一种简单的方法将用于评估前交叉韧带重建患者的2D X光片角度测量值转换为3D值，并将这些测量值与使用传统MRI和CT计算出的三维角度进行比较。
这项回顾性研究纳入了38例行解剖学前交叉韧带重建的患者。分析术后X光片和MR图像以确定胫骨隧道角度。对从2D X光片计算出的角度与MRI测量的实际3D角度之间的相关性进行了统计分析。
分析表明，X光片上的胫骨隧道角度与MRI之间存在很强的相关性，差异极小且无统计学意义。这表明X光片可以提供对胫骨隧道角度的可靠估计。
这些发现表明，X光片在ACL重建中预测胫骨隧道角度的准确性与MRI相当。该方法可以指导正确的隧道角度并便于术后评估。需要进一步研究以在不同人群和技术中证实这些结果。
