"Inching closer to native anatomy: A CT scan based morphometric analysis of tunnels in all-inside ACL reconstruction"

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-24 DOI:10.1016/j.jcot.2025.103072

Imroz Jindal , Kamparsh Thakur , Chander Mohan Singh , Chetan Sood , Saurabh Mahajan , Mohini Agrawal

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引用次数: 0

Abstract

Background

Placement of ACL tunnels closer to native ACL footprint is of utmost importance. Thus, study was designed to analyze radiomorphometric parameters of tunnels in All-inside technique (AI) and compare them to Antero-medial portal with full Tibial tunnel technique (AMP).

Methods

Observational study was conducted from January 2019 to December 2021. Participants were divided into two groups for single bundle ACL reconstruction: AI and AMP. Radiomorphometric analysis of tunnels was done on CT-scan. Paired t-test was used for comparison, with p < 0.05 considered to be significant.

Results

60 patients were included in the study, with one female and 29 males, with no significant differences in demographic parameters (p = 0.0554). For femoral tunnels, t% was 22.27 ± 3.677 and 22.506 ± 2.481; h% was 29.92 ± 3.255 and 27.654 ± 2.938 for AMP and AI respectively, with no significant differences. For tibial tunnels, ap% was 45.658 ± 3.33 and 46.008 ± 3.448; ml% was 51.247 ± 1.91 and 52.035 ± 2.533 for AMP and AI, respectively. There was no significant differences for t% (p = 0.84), h% (p = 0.0551), ap% (p = 0.7794), and ml% (p = 0.3443). Mean diameter of femoral tunnels was 9.43 ± 0.75 mm and 9.16 ± 0.58 mm, and tibial tunnels were 9.43 ± 0.70 mm and 9.06 ± 0.70 mm for AMP and AI, respectively, with no statistical difference. The length of femoral tunnels was 20.146 ± 3.256 mm and 21.64 ± 2.011 mm, and tibial tunnels were 39.16 ± 5.447 mm and 20.72 ± 3.68 mm for AMP and AI respectively, showing a significant difference in tibial tunnel length (p < 0.00001). No significant difference was noted in sagittal orientation in two techniques. However, a significant difference was noted in coronal alignment for femoral tunnels (p < 0.0001).

Conclusion

There is no significant differences in femoral and tibial tunnel placement, length, diameter, and sagittal orientation. However, significant difference was noted in femoral tunnels' coronal orientation and tibial tunnels’ length. Drilling femoral tunnel at 90° enhances ease of placement for femoral-jig but does not affect tunnel placement.

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“逐渐接近原生解剖：基于CT扫描的全内交叉韧带重建隧道形态分析”

将ACL隧道放置在更接近本机ACL足迹的位置是至关重要的。因此，本研究旨在分析全内通道技术（AI）隧道的放射形态学参数，并将其与前内侧门静脉与全胫骨隧道技术（AMP）进行比较。方法观察性研究于2019年1月至2021年12月进行。参与者被分为两组进行单束ACL重建：AI和AMP。在ct扫描上进行隧道放射形态分析。比较采用配对t检验，p <；0.05被认为是显著的。结果60例患者纳入研究，其中女性1例，男性29例，人口学参数差异无统计学意义（p = 0.0554）。股骨隧道t%分别为22.27±3.677和22.506±2.481；AMP和AI的h%分别为29.92±3.255和27.654±2.938，差异无统计学意义。胫骨隧道ap%分别为45.658±3.33和46.008±3.448；AMP和AI的ml%分别为51.247±1.91和52.035±2.533。t% （p = 0.84）、h% （p = 0.0551）、ap% （p = 0.7794）和ml% （p = 0.3443）差异无统计学意义。AMP和AI的股骨隧道平均直径分别为9.43±0.75 mm和9.16±0.58 mm，胫骨隧道平均直径分别为9.43±0.70 mm和9.06±0.70 mm，差异无统计学意义。AMP和AI的股骨隧道长度分别为20.146±3.256 mm和21.64±2.011 mm，胫骨隧道长度分别为39.16±5.447 mm和20.72±3.68 mm，胫骨隧道长度差异有统计学意义(p <；0.00001)。两种技术在矢状面定位上无显著差异。然而，在股动脉隧道的冠状位对准方面存在显著差异(p <；0.0001)。结论股骨和胫骨隧道的位置、长度、直径和矢状位无明显差异。然而，股骨隧道的冠状方向和胫骨隧道的长度有显著差异。以90°角度钻孔股骨隧道可提高股骨夹具放置的便利性，但不影响隧道放置。

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

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.