Radiologic and Clinical Evaluation after Arthroscopic Reconstruction of Anterior Cruciate Ligament Using Autogenous Bone-Patellar Tendon-Bone Graft.
- Author:
Hyoung Soo KIM
1
;
Seung Rim PARK
;
Joon Soon KANG
;
Woo Hyeong LEE
;
Seung Joon PARK
Author Information
1. Department of Orthopedic Surgery, Inha University, Inha General Hospital, Sungnam, Korea.
- Publication Type:Original Article
- Keywords:
ACL;
Divergence of interference screw;
Tunnel placement
- MeSH:
Anterior Cruciate Ligament*;
Axis, Cervical Vertebra;
Bone-Patellar Tendon-Bone Grafts*;
Humans;
Knee;
Physical Examination
- From:Journal of the Korean Knee Society
1999;11(2):155-162
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to correlate radiological analysis(as divergence of femoral tun-nel and interference screw and tunnel placement) with clinical results(as physical examination, Lysholm knee scoring scale, and side to side difference of anterior displacement in an arthrometer). MATERIALS AND METHODS: This study reviewed radiological and clinical results in 48 endoscopic single-incision ACL reconstruction, using autogenous bone-patellar tendon-bone graft and interference screw fixation, between January 1995 and October 1997. We measured the femoral divergence in antero-poste-rior and lateral views of the knee(APD/LD), the angle between a line through the longitudinal axis of dis-tal femoral shaft, and the axis of femoral tunnel in antero-posterior and lateral views(APFT/LFT). We also measured the placement of a tunnel in antero-posterior and lateral views. RESULTS: Significant correlation was present between APD and APFT(negatively) and between LD and LFT(positively), while other variables had no significant correlation. Furthermore, there was no signifi-cant correlation between divergence and clinical results. Clinical results correlated positively with posteri-or femoral tunnel placement on lateral radiographs and negatively with excessive anterior tibial tunnel placement. Therefore, when femoral tunnels were placed at least 60% posterior along the Blumenssat's line and tibial tunnels were placed at least 20% posterior along the tibial plateau, 77.1% of the patients had good or excellent Lysholm score and 80% of the patients had a KT-2000 Arthrometer maximum manual side-to-side difference of 3 mmor less. When the above criteria were not met, however, only 53.8% of the patients had good or excellent Lysholm score and 53.8% had a KT-2000 Arthrometer maximum manual side-to-side difference of 3 mmor less. CONCLUSIONS: This close correlation indicated that satisfactory radiographic tunnel position influences the outcome of an ACL reconstruction.
