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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Radiographic Location Does Not Ensure a Precise Anatomic Location of the Femoral Fixation Site in Medial Patellofemoral Ligament Reconstruction
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Radiographic Location Does Not Ensure a Precise Anatomic Location of the Femoral Fixation Site in Medial Patellofemoral Ligament Reconstruction

机译：射线照相位置不会确保股骨状髌骨韧带重建中股骨固定部位的精确解剖位置

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Background:A frequently used method to determine the anatomic femoral fixation point in the operating room during medial patellofemoral ligament (MPFL) reconstruction is the radiographic method. However, the ability of this radiological method to establish an anatomic femoral attachment point might not be as accurate as expected.Purpose:(1) To evaluate the accuracy of the radiological method to locate the anatomic femoral fixation point in MPFL reconstruction surgery and (2) to determine the factors influencing the predictability of this method to obtain this objective.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:A total of 100 consecutive 3-dimensional computed tomography (3D CT) knee examinations were performed at 0° of extension in 87 patients treated for chronic lateral patellar instability. For each knee, 2 virtual 7 mm–diameter femoral tunnels were created: 1 using the adductor tubercle as a landmark (anatomic tunnel) and the other according to the radiological method described by Sch?ttle et al (radiographic tunnel). We measured the percentage of overlap between both tunnels. Moreover, of the 100 included knees, 10 were randomly selected for a variability study.Results:Considering an overlap area greater than 50% as reasonable, the radiographic method achieved this in only 38 of the 100 knees. Intrarater and interrater reliability were excellent. There was a trend for female patients with severe trochlear dysplasia to have less overlap. This model accounted for 64.2% of the initial variability in the data.Conclusion:An exact anatomic femoral tunnel placement could not be achieved with the radiographic method. Radiography provided only an approximation and should not be the sole basis for the femoral attachment location. Moreover, in female patients with severe trochlear dysplasia, the radiographic method was less accurate in determining the anatomic femoral fixation point, although differences were not statistically significant.
机译：背景：在内侧髌韧带（MPFL）重建期间，常用方法以确定手术室中的手术室中的解剖学股票固定点是射线照相方法。然而，这种放射方法建立解剖学股骨附着点的能力可能与预期的那样是准确的。：（1）评估放射学方法的准确性，以定位MPFL重建手术中的解剖学股骨固定点和（2 ）确定影响该方法可预测性的因素，以获得这一目标。研究设计：队列研究（诊断）;证据水平，2.方法：在为慢性侧髌骨不稳定性治疗的87名患者中，在0°延伸时进行总共100个连续的三维计算断层扫描（3D CT）膝关型检查。对于每个膝关节，创建了2个虚拟7毫米直径的股隧道：1使用收集器结节作为地标（解剖隧道），另一个根据SCH的放射方法（放射线隧道）所描述的放射线方法。我们在两个隧道之间测量了重叠的百分比。此外，在100个包括膝盖中，随机选择10用于变异研究。结果：考虑到大于50％的重叠面积为合理，射线照相方法仅在100个膝上的38中实现了这一点。内部和Interrater可靠性很好。女性患者患有严重Trochlear发育不良的趋势较少。该模型占数据的初始变异性的64.2％。结论：通过射线照相方法无法实现精确的解剖学股隧道放置。造影仅提供近似，不应该是股骨连接位置的唯一基础。此外，在患有严重Trochlear发育不良的女性患者中，在确定解剖学股骨固定点时，射线照相方法在不太准确，尽管差异没有统计学意义。

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