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首页> 外文期刊>Journal of orthopaedic research >Variations in the three-dimensional location and orientation of the ACL in healthy subjects relative to patients after transtibial ACL reconstruction
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Variations in the three-dimensional location and orientation of the ACL in healthy subjects relative to patients after transtibial ACL reconstruction

机译：胫骨ACL重建后健康受试者相对于患者的ACL三维位置和方向的变化

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Recent reports have indicated that anatomical placement of the anterior cruciate ligament (ACL) graft is an important factor for restoration of joint function following ACL reconstruction. The objective of this study was to address a need for a better understanding of anatomical variations in ACL position and orientation within the joint. Specifically, variations in the ACL anatomy were assessed by testing for side-to-side ACL footprint location symmetry in a healthy population relative to the operative and contralateral knee in a patient population after traditional transtibial single-bundle ACL reconstruction. MRI and three-dimensional modeling techniques were used to determine the in vivo tibiofemoral ACL footprint centers and the resulting ACL orientations in both knees of 30 healthy subjects and 30 subjects after transtibial ACL reconstruction. While there were substantial inter-subject variations in ACL anatomy, the side-to-side RMS differences in the ACL footprint center were 1.20 and 1.34 mm for the femur and tibia, respectively, for the healthy subjects and no clinically meaningful intra-subject differences were measured. However, there were large intrasubject side-to-side differences after transtibial ACL reconstruction, with ACL grafts placed 5.63 and 7.64 mm from the center of the contralateral femoral and tibial ACL footprint centers, respectively. Grafts were placed more medial, anterior, and superior on the femur and more posterior on the tibia; producing grafts that were more vertical in the sagittal and coronal planes. Given the large variation among subjects, these findings advocate the use of the contralateral ACL morphology for retrospectively evaluating patient-specific anatomic graft placement.
机译：最近的报道表明，前交叉韧带（ACL）移植物的解剖位置是重建ACL后恢复关节功能的重要因素。这项研究的目的是要解决对关节内ACL位置和方向的解剖变化的更好理解的需求。具体而言，通过测试健康人群中相对于传统胫骨单束ACL重建后患者人群中手术和对侧膝关节的左右ACL足迹位置对称性，来评估ACL解剖结构的变化。 MRI和三维建模技术用于确定30例健康受试者和30例经胫骨ACL重建后的体内胫股ACL足迹中心以及所得到的ACL方向。尽管ACL解剖结构存在较大的受试者间差异，但健康受试者的股骨和胫骨的ACL足迹中心的左右RMS差异分别为1.20和1.34 mm，并且没有临床意义的受试者内差异被测量。然而，经胫骨ACL重建后，受试者之间的侧向差异很大，分别将ACL移植物放置在距对侧股骨和胫骨ACL足迹中心的5.63和7.64 mm处。移植物放置在股骨的内侧，前方和上方，胫骨的位置更靠后。产生在矢状和冠状平面上更垂直的移植物。考虑到受试者之间的巨大差异，这些发现主张使用对侧ACL形态来回顾性评估患者特定的解剖移植位置。

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