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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Computed Tomography Assessment of Anatomic Graft Placement After ACL Reconstruction: A Comparative Study of Grid and Angle Measurements
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Computed Tomography Assessment of Anatomic Graft Placement After ACL Reconstruction: A Comparative Study of Grid and Angle Measurements

机译：ACL重建后解剖移植位置的计算机断层扫描评估：网格和角度测量的比较研究

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Background: The anatomic placement of anterior cruciate ligament (ACL) grafts is often assessed with postoperative imaging. In clinical practice, graft angles are measured to indicate anatomic placement on magnetic resonance imaging, whereas grid measurements are performed on computed tomography (CT). Recently, a study indicated that graft angle measurements could also be assessed on CT. No consensus has yet been reached on which measurement method is best suited to assess anatomic graft placement. Purpose: To compare the ability of grid measurements and angle measurements to identify anatomic versus nonanatomic tunnel placement on CT performed in patients undergoing ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: A total of 100 knees undergoing primary reconstruction with a hamstring graft (HAM group), 91 undergoing reconstruction with a bone–patellar tendon–bone graft (BPTB group), and 117 undergoing revision ACL reconstruction (REV group) were assessed with CT. Grid measurements of the femoral and tibial tunnels and angle measurements of grafts were performed. Graft placement, rated as anatomic or nonanatomic, was assessed with both methods. Pearson chi-square, analysis of variance, Kruskal-Wallis, and weighted kappa tests were performed as appropriate. Results: The grid assessment classified 10% of the HAM group, 4% of the BPTB group, and 17% of the REV group as nonanatomic ( P & .001). The angle assessment classified 37% of the HAM group, 54% of the BPTB group, and 47% of the REV group as nonanatomic. The weighted kappa between angle measurements and grid measurements was low in all groups (HAM: 0.009; BPTB: 0.065; REV: 0.041). Conclusion: The agreement between grid measurements and angle measurements was very low. The angle measurements seemed to overestimate nonanatomic tunnel placement. Grid measurements were better in identifying malpositioned grafts.
机译：背景：前交叉韧带（ACL）移植物的解剖位置通常通过术后影像学评估。在临床实践中，对移植物的角度进行测量以指示在磁共振成像上的解剖位置，而在计算机断层扫描（CT）上进行栅格测量。最近，一项研究表明，也可以在CT上评估移植角度。关于哪种测量方法最适合评估解剖移植物的位置，尚未达成共识。目的：为了比较在进行ACL重建的患者中进行CT的网格测量和角度测量识别解剖和非解剖隧道放置的能力。研究设计：案例系列;证据等级：4。方法：共有100例膝关节进行了string绳肌腱的初次重建（HAM组），91例进行了骨pat腱-骨移植的重建（BPTB组），而117例进行了ACL翻修（REV）组）进行CT评估。进行股骨和胫骨隧道的网格测量以及移植物的角度测量。两种方法均评估了移植物的位置，评定为解剖学或非解剖学。进行了皮尔逊卡方检验，方差分析，Kruskal-Wallis和加权kappa检验。结果：网格评估将HAM组的10％，BPTB组的4％和REV组的17％归类为非解剖型（P <.001）。角度评估将HAM组的37％，BPTB组的54％和REV组的47％归类为非解剖型。在所有组中，角度测量和网格测量之间的加权卡伯值都很低（HAM：0.009; BPTB：0.065; REV：0.041）。结论：网格测量和角度测量之间的一致性非常低。角度测量似乎高估了非解剖隧道的位置。网格测量可以更好地识别错位的移植物。

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