Optimizing Femoral Tunnel Placement in ACL Reconstruction: Effect of a 70-degree Arthroscope and Portal Position

IF 0.2 Q4 ORTHOPEDICS

Techniques in Orthopaedics Pub Date : 2024-07-01 DOI:10.1097/bto.0000000000000673

Tanvir Khan, Sami Al-Ali, A. Alvand, William F. M. Jackson, Yusuf O. Hasan, David J. Beard, H. S. Gill, Andrew J. Price

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引用次数: 0

Abstract

The aim of this study was to assess the accuracy of femoral tunnel placement for anterior cruciate ligament reconstruction (ACLR) using either an accessory medial portal or a 70-degree arthroscope compared with the standard 2-portal technique. A computerized 3D model of the femur was obtained with 4 reference points marked around the LFC. Using the simulator, 2 surgeons marked 5 consecutive femoral tunnel points with a 30-degree arthroscope in the lateral portal (30AL), then with a 30-degree arthroscope in an accessory medial portal (30AM), and next with a 70-degree arthroscope in the lateral portal (70AL). This was repeated after one week. Subjects then marked their target femoral tunnel positions (T) on the free femur sawbone model. After each episode, the distances from the marked tunnel point to the 4 reference points (d1, d2, d3, d4) were measured. After mapping to the 3D femur model, the co-ordinates of each marked tunnel position were determined. The distance (r) from T was calculated for each episode. The median value of r was 1.27 mm(SE 0.15 mm) using 30AL, 0.54 mm (SE 0.12 mm) using the 30AM portal, and 0.20 mm (SE 0.047 mm) with 70AL. r was significantly smaller with 70AL (P<0.0001). The difference in r between 30AM and 30AL was also statistically significant (P=0.019). A 70-degree arthroscope in the lateral portal allows greater accuracy in femoral tunnel placement compared with a 30-degree arthroscope in either the lateral or an accessory medial portal.

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前交叉韧带重建中股骨隧道位置的优化：70 度关节镜和门户位置的影响

本研究旨在评估使用辅助内侧入口或70度关节镜进行前交叉韧带重建（ACLR）时股骨隧道置入的准确性，并与标准的双入口技术进行比较。我们获得了股骨的计算机三维模型，并在 LFC 周围标记了 4 个参考点。两名外科医生使用模拟器，先用 30 度关节镜在外侧入口（30AL）标记 5 个连续的股骨隧道点，然后用 30 度关节镜在辅助内侧入口（30AM）标记，接着用 70 度关节镜在外侧入口（70AL）标记。一周后重复上述步骤。然后，受试者在游离股骨锯骨模型上标记其目标股骨隧道位置 (T)。每次活动后，测量标记的隧道点到 4 个参考点（d1、d2、d3、d4）的距离。在映射到三维股骨模型后，确定每个标记隧道位置的坐标。计算出每一事件与 T 的距离 (r)。使用 30AL 时，r 的中值为 1.27 毫米（SE 0.15 毫米），使用 30AM 门户时为 0.54 毫米（SE 0.12 毫米），使用 70AL 时为 0.20 毫米（SE 0.047 毫米）。30AM 和 30AL 的 r 值差异也有统计学意义（P=0.019）。与使用外侧或辅助内侧入口的 30 度关节镜相比，使用外侧入口的 70 度关节镜可以更准确地放置股骨隧道。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Orthopaedics ORTHOPEDICS-

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The purpose of Techniques in Orthopaedics is to provide information on the latest orthopaedic procedure as they are devised and used by top orthopaedic surgeons. The approach is technique-oriented, covering operations, manipulations, and instruments being developed and applied in such as arthroscopy, arthroplasty, and trauma. Each issue is guest-edited by an expert in the field and devoted to a single topic.