关节镜下腘绳肌腱与后十字韧带重建术中腘动脉距离的磁共振成像评估。

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-01-03 DOI:10.1016/j.jor.2025.01.007

Steven Heylen , Peter Verdonk , Matthias Krause , Jozef Michielsen

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引用次数: 0

摘要

目的：关节镜治疗后外侧角损伤尚未被广泛接受。人们仍然担心在关节镜下进行这些重建时会造成神经血管（NV）损伤。本研究旨在通过磁共振扫描比较关节镜下腘绳肌腱重建术（APB）和关节镜下后交叉韧带重建术（APC）的胫骨隧道与腘绳神经血管束的距离：方法：对 93 名患者的 MRI 扫描结果进行评估。标记 APB 和 APC 重建的胫骨隧道出口点。评估这些隧道出口点中心到神经血管束的最小距离。评估平均方差和距离。计算韦尔奇非配对 t 检验。结果：APB手术中，从胫骨隧道到NV束的平均距离为15.9毫米。APC胫骨隧道到NV束的平均距离为11.2毫米。韦尔奇非配对 t 检验的 p 值为结论：从 APB 的胫骨隧道到 NV 束的距离明显高于从 APC 的胫骨隧道到 NV 束的距离。然而，APB 的 NV 束距离差异明显更大。因此，不应认为在 APB 中钻胫骨隧道比在 APC 中钻胫骨隧道更危险。

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Magnetic Resonance imaging evaluation of the distance to the popliteal artery in arthroscopic popliteus tendon versus posterior cruciate ligament reconstruction

Purpose

Wide acceptance of arthroscopically treating posterolateral corner injuries has not occurred. There remains a fear of neurovascular (NV) injury while arthroscopically performing these reconstructions. The study's aim is to compare on Magnetic Resonance Scans the distance of the tibial tunnel in an arthroscopic popliteus tendon reconstruction (APB) and arthroscopic posterior cruciate ligament (PCL) reconstruction (APC) to the popliteal neurosvascular bundle.

Methods

MRI scans of 93 patients were evaluated. The tibial tunnel exit point of an APB and an APC reconstruction was marked. The smallest distance of the center of the exit point of these tunnels to the NV bundle was assessed. Mean variances and distances were assessed. A Welch's unpaired t-test was calculated. The difference in variances was also assessed.

Results

Mean distance to NV bundle from the tibial tunnel in an APB procedure was 15.9 mm. The mean distance to the NV bundle from an APC tibial tunnel was 11.2 mm. The Welch's unpaired t-test p-value was <0.0001. The p-value of the test for equality of variances was 0.0002.

Conclusion

The distance to the NV bundle from the tibial tunnel of an APB is significantly higher than the distance to the NV bundle from the tibial tunnel of a APC. However, there is a significantly larger variance in distance to the NV bundle in an APB. Drilling a tibial tunnel during an APB should therefore not be considered more dangerous than drilling the tibial tunnel during an APC.

Level 4 LOE.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.