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首页> 外文期刊>Open access Journal of Sports Medicine >Comparison of transtibial and transportal techniques in drilling femoral tunnels during anterior cruciate ligament reconstruction using 3D-CAD models
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Comparison of transtibial and transportal techniques in drilling femoral tunnels during anterior cruciate ligament reconstruction using 3D-CAD models

机译：使用3D-CAD模型比较在前交叉韧带重建过程中钻入股骨隧道的胫骨和运输技术的比较

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Purpose: The purpose of this study was to assess the differences in bone tunnel apertures between the trans-accessory medial portal (trans-AMP) technique and the transtibial (TT) technique in double-bundle anterior cruciate ligament reconstruction. The extent of ovalization and the frequency of overlap of the two tunnel apertures were compared. Methods: The simulation of femoral tunnel drilling with the TT and the trans-AMP techniques was performed using three-dimensional computer aided design models from two volunteers. The incidence angle of drilling against the intercondylar wall, the femoral tunnel position, the ovalization, and the overlap were analyzed. The aperture and location of the tunnels were also examined in real anterior cruciate ligament reconstruction cases (n=36). Results: The surgical simulation showed that a lower drill incident angle induced by the TT technique made the apertures of two tunnels more ovalized, located anteromedial tunnels in a shallower position to prevent posterior wall blow out, and led to a higher frequency of tunnel overlap. The trans-AMP group had tunnel places within the footprint and had less ovalization and overlap. The results of analysis for tunnels in the clinical cases were consistent with results from the surgical simulation. Conclusion: In the TT technique, the shallow anteromedial tunnel location and more ovalized tunnel aperture can lead to a higher frequency of tunnel overlap. Compared with the TT technique, the trans-AMP technique was more useful in preparing femoral tunnels anatomically and avoiding tunnel ovalization and overlapping in double-bundle anterior cruciate ligament reconstruction.
机译：目的：本研究的目的是评估在双束前交叉韧带重建中跨附件内侧门（trans-AMP）技术和跨胫骨（TT）技术之间的骨隧道孔之间的差异。比较了两个隧道孔的椭圆化程度和重叠频率。方法：使用来自两名志愿者的三维计算机辅助设计模型对TT和trans-AMP技术进行股骨隧道钻孔的模拟。分析了against间壁钻孔的入射角，股骨隧道位置，卵形和重叠。在真正的前交叉韧带重建病例中（n = 36）也检查了隧道的孔径和位置。结果：外科手术模拟显示，通过TT技术产生的较低的钻头入射角使两个隧道的孔更加椭圆化，将前隧道定位在较浅的位置，以防止后壁爆裂，并导致更高的隧道重叠频率。 trans-AMP组在足迹内具有隧道位置，椭圆化和重叠较少。临床病例的隧道分析结果与手术模拟结果一致。结论：在TT技术中，较浅的前隧道位置和较大的椭圆形隧道孔径可导致更高的隧道重叠频率。与TT技术相比，trans-AMP技术在解剖学上准备股骨隧道以及避免在双束前交叉韧带重建中避免隧道椭圆化和重叠方面更为有用。

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