Comparison Of Femoral Tunnel And Early Curative Effect Analysis Between Arthroscopic Three Approach And Traditional Anteromedial Portal For Reconstruction Of Anterior Cruciate Ligament

Objective:To study the early effects and femoral tunnel of arthroscopy three-approach and traditional anterior medial technique to reconstruct anterior cruciate ligament.Methods:Through retrospective analysis,selected from December 2018 to June 2019,36 patients with hospitalized diagnosis of simple anterior cruciate ligament tear were selected and divided into two groups,of which a total of 16 patients,including 11 males and 5 females,with an average age of 30.13±6.54 years old,using three-approach technique to drill the femoral tunnel to reconstruct the anterior cruciate ligament;another group of 20 cases,including 15 males and 5 females,with an average age of 30.80±8.60 years old,using traditional anterior medial approach to drill the femoral tunnel to reconstruct the anterior cruciate ligament;the drilled femoral tunnel was evaluated by CT three-dimensional reconstruction technique,and the knee joint function was evaluated by the Lysholm score of the knee joint.Results:All patients achieved primary healing after the surgical incision.No femoral tunnel fracture,vascular and nerve damage,difficulty in graft passage during the operation.,and venous thrombosis occurred.All 36 patients were followed up on an outpatient basis,with a follow-up period of 9-15 months,with an average of 12±2.83 months.Three-dimensional CT reconstruction was used to evaluate the femoral tunnel of the two groups of patients.The position of the femoral tunnel was described using the quartilemethod as the three-approach group: the lower 27.83 ± 1.97% of the femoral condyle and the posterior 25.57 ± 3.20%;the traditional approach group: the lower 28.38 ± 3.21% of the femoral condyle and the posterior 26.23 ± 3.20%.Bone tunnel length,three-approach group: 35.20±5.52 mm in total length,23.20 ± 2.07 mm in thick bone tunnel;traditional approach group: 34.60 ± 4.26 mm in total length,22.56 ± 2.50 mm in thick bone tunnel.Coronal plane angle,three-approach group: 47.93 ± 5.98 °;traditional approach group:41.78 ± 6.62 °.Knee joint Lysholm score,three-approach group: 57.81±6.23 before surgery;97.00±2.48 at last follow-up after operation;traditional approach group:57.15±8.76 before surgery,97.30±2.68 at last follow-up after operation,there were significant differences before and after surgery,no statistically significant difference between groups.Conclusion:The positions of the femoral tunnel drilled by the two methods were within the range of the anatomic stop of the anterior cruciate ligament,and there was no statistical difference.Compared with the traditional anterior medial approach,the coronal plane angle of the femoral tunnel drilled by the three-approach approach is relatively large,and there is no statistical difference in the length of the tunnel.There is no statistical difference in the early postoperative effect of the two surgical methods.There was no statistical difference in the operation time.But the three approach has a wider and clearer vision.In addition,the knee flexion angle required for drilling the femoral tunnel during surgery is significantly smaller than that of traditional approach technology,which reduces the difficulty of surgery.