Clinical Comparison Study Of Anterior Cruciate Ligament Reconstruction Between Anterior Medial Bundle Center And Anatomical Footprint Center In Positioning The Femoral Attachment

Objectice :To compare the postoperative clinical outcomes and the shape of graft in the centre position at the femoral footprint of ACLR between the AMB and Anatomical footprints,and to provide a theoretical basis for selecting a better femoral tunnel’s centre point。Methods:A retrospective analysis of 82 patients who underwent arthroscopic single anterior cruciate ligament reconstruction(ACLR)surgery from September2013 to May 2018.Patients were divided into groups A and B according to the location of the femoral tunnel.Group A was 44 patients used the centre of anatomical footprints(35 males,9 females;19 left knees,25 right knees;30 cases of meniscus injuries,14 no meniscus injuries;average age is 26.27±7.00;average time of injury is5.17±9.07 months),In group B,38 cases were located at the center of the AMB footprint(27 males,11 females;15 left knees,23 right knees;24 cases of meniscus injuries,14 no meniscus injuries;average age is 27.47±8.40;The average time of injury is 7.52±13.48months).All patients were operated on by the same primary surgeon,followed by the same rehabilitation plan.All patients were followed up for more than 1 year,and the knee joints were examined by MRI at 1 year.The preoperative and postoperative knee function scores,pivot shift test,Lacnman test and the shape of graft in postoperative MRI were compared between the two groups,and analysis the correlation between the shape of graft in postoperative MRI grading and postoperative knee function and graft angle.Results:Two kinds of the femoral tunnel’s centre positioning can achieve satisfactory clinical effect after ACLR.There was no significant difference in clinical effect,pivot shift test and Lachman between the two groups after operation(P>0.05).The reconstruction of the anterior medial bundle centre was better than that of the anatomic footprints centre in the imaging grading of the graft(P < 0.05).The MRI grades of the grafts in the two groups were correlated with the knee joint function(R=-0.348,P=0.001),and the MRI grades of the grafts were related to thesagittal obliquity within the anatomical ACL angle(R =-0.326,P = 0.03).Conclusions: After more than one year follow-up,there was no significant difference in the clinical outcomes between the two kinds of the femoral tunnel’s centre during the short-term follow-up.The reconstruction of the anterior medial bundle centre was better than that of the anatomic footprints centre in the imaging grading of the graft(P < 0.05)...