Three-dimensional Computed-tomography Reconstruction Evaluation Of Knee Kinematics After Anterior Cruciate Ligament Reconstruction With Anteromedial And Transtibial Femoral Tunnel Drilling Techniques

Objective: To evaluate the three-dimensional CT reconstruction by anteromedialAM (anteromedial) and the tibial tunnel into the the road TT (transtibial) to establishfemoral tunnel of two surgical methods in patients with anterior cruciate ligamentreconstruction of knee movement school level, to provide a theoretical basis to selectthe better of the anterior cruciate ligament reconstruction surgery way.Methods:17cases of patients with arthroscopic ACL reconstruction:9AMmethod complete ACL reconstruction (5males and4females, mean age was35±8years),8patients with complete ACL reconstruction using the TT method (male5cases,3females, mean age33±6years old). CT scan in all patients in the two weeks afterline64-slice spiral CT scan, knees and contralateral normal knee125N external forceand removal of the external force downward knee fully extended (knees0°) and30°offlexion and fully extended bit and30°of flexion degree three-dimensionalreconstruction of the image line. The three-dimensional reconstruction imagescombined2D/3D image registration techniques use Geomagic8.0software, measuredbefore and after the knee with the contralateral normal knee tibial shift and the shiftdistance, rotation angle, and tibial-femoral contact area, and other parameters.Reconstruction group and the contralateral normal knee as an independent experimentalgroup statistics. Data reconstruction group comparison analysis of variance on themeasurement data of the contralateral knee. P <0.05was prompted statisticallysignificant.Results: AM ACL reconstruction patient group kinematic measurements nosignificant difference with the contralateral normal knee. The TT group results prompted postoperative tibial rotation angle was significantly greater than thecontralateral knee (TT,7.8°±3.4°, the contralateral,2.5°±6.1°)(P=0.02). AMgroup tibia rotation angle with no significant difference in the contralateral (AM,3.2°±5.7°, contralateral,2.1°±5.2°)(P=0.38). In the knee extension position (knees0°),the TT group tibial external rotation was significantly greater than the contralateralgroup. TT group tibial shift distance is greater than the contralateral group (P=0.01),the difference was significant; AM group was no significant difference (P=0.42) andcontralateral knee. The AM group results suggest that knee lateral compartment tibial-femoral contact area is larger than the contralateral group, the TT group difference wasnot statistically significant.Conclusion: The three-dimensional CT reconstruction techniques the AM methodrow the ACLR ratio of TT methods better able to repair the kinematics of the knee level(including before and after anti-tibial within the shift and rotation) can be found, butalso increase the relaxation of the knee degrees. The results of this experiment supportthe bodies and Clinical Research Institute found AM better than the TT method torestore the anatomy and stability of the knee. However, due to the limitations of thisstudy, the increase of the contact area in the AM group clinical importance is stillunknown.