A comparative study of the position of the femoral tunnel in anterior cruciate ligament reconstruction between using bony landmark and measuring method
10.3969/j.issn.1000-6710.2024.10.001
- VernacularTitle:骨性标志定位与测量定位在前交叉韧带重建中股骨骨道位置对比研究
- Author:
Yan DONG
1
;
Jingbin ZHOU
;
Peng CUI
Author Information
1. 首都医科大学附属北京同仁医院骨科,北京 100730
- Publication Type:Journal Article
- Keywords:
ACL injury;
anatomical reconstruction;
bony landmarks;
measuring
- From:
Chinese Journal of Sports Medicine
2024;43(10):771-776
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the distribution of bone tunnel positions in anterior cruciate liga-ment(ACL) anatomic reconstruction surgery using the bony landmark method and the measuring meth-od for femoral positioning,respectively,so as to explore better positioning methods for ACL on the femoral side.Methods The data of 90 patients who underwent arthroscopic ACL single-bundle anatomi-cal reconstruction surgery in our department between October 2016 and July 2021 were analyzed retro-spectively.Patients with the femoral tunnel localized according to the resident's ridge and the bifur-cate ridge were selected into the bony landmark group(n=34),including 26 males and 8 females(19 left knees,15 right knees,and aged 30.8±4.6 years) while those with the femoral tunnel localized using ruler measurements were chosen into the measuring method group(n=56),consisting of 42 males and 14 females(32 left knees and 24 right knees,aged 31.7±5.3).A rectangular frame was drawn on the three-dimensional CT lateral view of the femur,and the bone canal position was located accord-ing to the proportion of the bone canal center point in the deep-shallow direction and the high-low di-rection of the rectangle frame.The distribution of the position in each direction and the degree of the tunnel position were compared between the two groups.Results In the deep-shallow direction in femo-ral epicondyle,4,23 and 7 of the bony landmark method group were of the posterior,normal and an-terior position,showing significant differences from those of the measuring method group(7,47 and 2).Moreover,significant differences were also observed in the number of patients with high/normal/low positions in the high-low direction,which was 22/11/1 in the bony landmark method group and 6/48/2 in the measuring method group(P<0.01).Meanwhile,the percentage of good bone tunnel positioning in the bony landmark method group was 26.5％,significantly lower than the measuring method group of 80.4％(P<0.01).Conclusion In anatomical reconstruction of the ACL,the measuring method is superi-or to the bony landmark method in the femoral tunnel positioning.
