经CT三维重建后的关节镜下全内与传统前交叉韧带重建的胫骨骨道对比

Comparison of Tibial Tunnels between All-Inside and Conventional Arthroscopic Anterior Cruciate Ligament Reconstruction after CT Three-Dimensional Reconstruction

摘要: 目的：本研究旨在研究全内及传统前交叉韧带重建中胫骨骨道的位置及长度差异。方法：回顾性分析40例接受前交叉韧带重建的患者，其中传统重建组20人，全内重建组20人，利用术后CT断层扫描数据建立三维模型，利用象限法测量胫骨骨道内口中心在胫骨平面上的位置，以及胫骨骨道在矢状面、冠状面的角度、胫骨骨道的长度。结果：利用象限法测得胫骨骨道内口在胫骨平面上的位置数据如下：前后位置：全内组(32.95% ± 5.60%)，传统组(34.45% ± 4.60%)，内外位置：全内组(47.77% ± 4.26%)，传统组(49.63% ± 2.66%)，两种手术方式的胫骨骨道内口中心在胫骨平面位置上无显著差异(P > 0.05)。矢状面胫骨骨道角度：全内组(56.80˚ ± 6.31˚)，传统组(53.03˚ ± 5.68˚)，冠状面胫骨骨道角度：全内组(78.97˚ ± 4.17˚)，传统组(78.41˚ ± 5.22˚)，两种手术方式在胫骨骨道角度方面无显著差异(P > 0.05)。骨道长度：全内组(4.17 ± 0.79 cm)，传统组(4.24 ± 0.54 cm)，两种手术方式在骨道长度方面无显著差异(P > 0.05)。结论：本研究通过CT三维重建技术对全内术式和传统前内入路重建术式进行比较，在胫骨骨道空间参数方面未发现明显差异。

Abstract: Objective: This study aims to investigate the differences in tibial tunnel position and length between all-inside and conventional anterior cruciate ligament reconstruction. Methods: A retrospective analysis was performed on 40 patients who underwent ACL reconstruction (20 in the conventional group, 20 in the all-inside group). Postoperative CT data were used to reconstruct three-dimensional models. The quadrant method was applied to measure the position of the tibial tunnel aperture on the tibial plateau, the tunnel angles in the sagittal and coronal planes, and the tibial tunnel length. Results: According to the quadrant method, the position of the tibial tunnel aperture on the tibial plateau was as follows: anterior-posterior position—all-inside group (32.95% ± 5.60%), conventional group (34.45% ± 4.60%); medial-lateral position—all-inside group (47.77% ± 4.26%), conventional group (49.63% ± 2.66%). No significant difference was found between the two surgical techniques regarding the position of the tibial tunnel aperture on the tibial plateau (P > 0.05). The tibial tunnel angle in the sagittal plane was 56.80˚ ± 6.31˚ in the all-inside group and 53.03˚ ± 5.68˚ in the conventional group; in the coronal plane, it was 78.97˚ ± 4.17˚ in the all-inside group and 78.41˚ ± 5.22˚ in the conventional group. No significant difference was observed in tibial tunnel angles between the two techniques (P > 0.05). The tibial tunnel length was 4.17 ± 0.79 cm in the all-inside group and 4.24 ± 0.54 cm in the conventional group, and there was no significant difference between the two groups (P > 0.05). Conclusion: Based on CT three-dimensional reconstruction, this study found no significant differences in tibial tunnel spatial parameters between the all-inside technique and the conventional anteromedial portal technique.