| Background:Anterior Cruciate Ligament(ACL)injury is a common injury of knee joint,which can cause serious complications.Arthroscopic ACL reconstruction is currently the most common treatment for ACL injury.The ideal attachment point of graft should be similar to the physiological ACL attachment point,which can achieve anatomical reconstruction.However,the size,shape,and position of ACL have individualized differences.Even gender is an important factor that causes individualized differences.Using general anatomical concepts and tunnel localization methods has greater limitations and it is difficult to achieve personalized surgery.Although ACL reconstruction has a high success rate,there are still some failure rates and revision rates reported in the literature.Which is mainly related to the positioning of the bone tunnel and whether the reconstructed ligaments are located in anatomical position.Therefore,the anatomy of the ACL is particularly important.The main purpose of this study is to use CT and MRI images to establish an accurate two-modal ACL three-dimensional digital model.The establishment of three-dimensional digital model is one of the means to understand the anatomical structure and function of the knee joint.A realistic model can completely reproduce the structure and function of the knee joint,and observe the points and faces in any plane and at any angle.Accurate ACL three-dimensional structure can provide preoperative reference,intraoperative positioning,and postoperative follow-up for ACL reconstruction,improve surgical accuracy evaluation,and reduce complications.Objective:CT and MRI images were used to construct a three-dimensional digital ACL model of human knee joint by three-dimensional digital imaging technology,and the accuracy of length,width,thickness,areas,and angles of the three anatomical planes of the human body were verified.To provide anatomical data and new methods and techniques based on digital anatomy for the accurate positioning of ACL walking,femoral and tibial bone tunnels during anatomical ACL reconstruction,and to provide preoperative reference before individual ACL reconstruction.Methods:Ten anatomical specimens of human knee joints were numbered from 1 to 10.CT and MRI scans were performed after the knee joint was flexed at a position of 10°to 15°with a splint.Using the three-dimensional imaging software to build two-modal ACL three-dimensional digital model with CT and MRI scans.The length,width,thickness of the ACL,the angles of the three anatomical planes,the location and area of the tibial and femoral attachment point were measured.Anatomical specimens of human knee joints were dissected,and the corresponding anatomical data were measured.Statistical analysis was performed with data to evaluate the reliability of the model.Using this technique to construct an ACL model of the contralateral ACL in patients with unilateral chronic ACL injury,and by mirroring to the ACL of the affected knee,measuring the anatomic data of the ACL model of the affected side and making an preoperative reference.Results:The data of the two-modal ACL three-dimensional digital model showed:The mean length,width and thickness of ACL were(40.38±1.10)mm?(10.17±0.34)mm?(6.07±0.31)mm respectively,and the angle formed by the coronal plane,sagittal plane,horizontal plane were(27.13±1.61)°,(40.05±1.90)°,(21.07±2.22)°respectively,ACL femoral attachment area(120±8.01)mm~2,tibial attachment area(94.4±7.64)mm~2.The data of anatomical specimens of human knee joints showed:the length,width and thickness of ACL were(39.60±1.10)mm?(10.41±0.37)mm?(6.17±0.19)mm respectively,and the angle formed by the coronal plane,sagittal plane,horizontal plane were(26.37±1.84)°,(39.68±2.07)°,(22.49±2.39)°respectively,ACL femoral attachment area(126±15.65)mm~2,tibial attachment area(97.9±8.37)mm~2.Compared with the data by paired sample t test,there was no significant difference(P>0.05).The data of affected side for ACL model showed:the length,width and thickness of ACL were 36.3mm,9.6mm,5.9mm respectively,the angle formed by the coronal plane,sagittal plane,horizontal plane were 25.7°,40.9°,20°respectively,ACL femoral attachment area 160mm~2,tibial attachment area 100mm~2.The location of ACL bone tunnels in arthroscopy was basically consistent with the location of the model.Conclusion:In this study,CT and MRI images were used to construct a two-modal ACL three-dimensional digital model of knee joint.There was no statistical difference between the anatomic data of the model and anatomical specimens of human knee joints,confirming the accuracy and reliability of the model.The use of this technology can provide a preoperative reference of ACL reconstruction. |
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