在三维CT上，通过股骨骨脊后隧道的虚拟三束前交叉韧带移植物显示出与原始前交叉韧带相同的定位。

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-01-03 DOI:10.1002/jeo2.70125

Narihiro Okazaki, Konsei Shino, Hiroyuki Yokoi, Tomoki Ohori

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引用次数: 0

摘要

目的：明确虚拟前交叉韧带（ACL）移植物模拟原生ACL的股骨隧道位置。方法：对14例完全伸展的正常膝关节进行三维（3D）计算机断层扫描（CT）和磁共振成像（MRI）检查。建立了两种虚拟三束ACL移植物。其中一种是基于骨标记策略（BR-VACLG组）将前内侧束（AM = AMM/前内侧束内侧+ AML/前内侧束外侧）和后外侧束（PL）的股骨隧道定位在居民脊（RR）后。在另一种类型中，隧道放置在RR （OR-VACLG组）上。在3D CT上将AM和PL的股骨附着区域的两个中心与AMM、AML和PL附着的三个胫骨足迹的两个中心连接起来，显示为三条直线，然后在MRI上叠加。比较正常ACL （N-ACL）、BR-VACLG和OR-VACLG的ACL/ACL移植物-胫骨平台（ACL- tp）角度。结果：N-ACL、BR-VACLG和OR-VACLG在斜冠状面上的平均ACL-TP角度分别为74.4±3.4°、75.2±4.5°和68.7±5.0°，AMM为81.9±3.8°、82.9±5.1°和76.3±4.0°，AML为71.1±6.4°、70.0±7.2°和61.0±4.7°；AMM为55.3±4.9°53.9±4.4°和50.5±4.3°；54.9°±4.5,54.7±2.6°和50.7±3.2°AML;斜矢状面PL分别为51.4±3.3°、51.2±2.4°和48.1±2.0°。N-ACL与BR-VACLG的角度差异无统计学意义，而OR-VACLG的AMM和PL的角度明显低于N-ACL。结论：三维CT上经股骨隧道经RR后的虚拟三束前交叉韧带移植物在MRI上显示完全伸展时与原始前交叉韧带方向相当。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Virtual triple-bundle ACL graft via femoral tunnels behind the resident's ridge on 3D CT demonstrates equivalent orientation to native ACL

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Virtual triple-bundle ACL graft via femoral tunnels behind the resident's ridge on 3D CT demonstrates equivalent orientation to native ACL

Purpose

To clarify the femoral tunnel location for a virtual anterior cruciate ligament (ACL) graft to simulate the native ACL.

Methods

Three-dimensional (3D) computed tomography (CT) and magnetic resonance imaging (MRI) were obtained in 14 normal knees in full extension. Two types of virtual triple bundle ACL grafts (VACLG) were created. In one type, the femoral tunnels for anteromedial bundle (AM = AMM/anteromedial bundle medial part + AML/anteromedial bundle lateral part) and posterolateral bundle (PL) were positioned behind the resident's ridge (RR) based on the bone landmark strategy (BR-VACLG group). In the other type, the tunnels were placed on the RR (OR-VACLG group). VACLG was displayed as three straight lines by connecting the two centres of the femoral attachment areas of AM and PL to those of the three tibial footprints of AMM, AML and PL attachments on 3D CT, and then superimposed on MRI. The ACL/ACL graft-the tibial plateau (ACL-TP) angles were compared among normal ACL (N-ACL), BR-VACLG and OR-VACLG.

Results

The mean ACL-TP angles of N-ACL, BR-VACLG and OR-VACLG were 74.4 ± 3.4°, 75.2 ± 4.5° and 68.7 ± 5.0° for AMM, 81.9 ± 3.8°, 82.9 ± 5.1° and 76.3 ± 4.0° and for AML, 71.1 ± 6.4°, 70.0 ± 7.2° and 61.0 ± 4.7° for PL on the oblique-coronal slices; 55.3 ± 4.9° 53.9 ± 4.4° and 50.5 ± 4.3° for AMM; 54.9 ± 4.5°, 54.7 ± 2.6° and 50.7 ± 3.2° for AML; 51.4 ± 3.3°, 51.2 ± 2.4° and 48.1 ± 2.0° for PL on the oblique-sagittal slices. There was no significant difference in the angles between N-ACL and BR-VACLG, while those of AMM and PL in OR-VACLG were significantly lower compared to N-ACL.

Conclusion

The virtual triple bundle ACL graft via femoral tunnels behind the RR on 3D CT shows equivalent orientation to the native ACL on MRI in full extension.