PDF(Pubmed)
Abstract：
UNASSIGNED: Socket-tunnel overlap during meniscal allograft transplantation (MAT) combined with anterior cruciate ligament reconstruction (ACLR) may compromise graft integrity and lead to impaired fixation and treatment failure.
UNASSIGNED: The purpose of this study was to determine optimal socket-tunnel drilling parameters for medial and lateral MAT with concurrent ACLR using artificial tibias and computed tomography (CT) scans for 3-dimensional (3D) modeling. It was hypothesized that clinically relevant socket tunnels could be created to allow for concurrent medial or lateral MAT and ACLR without significant risk for overlap at varying tunnel guide angles.
UNASSIGNED: Descriptive laboratory study.
UNASSIGNED: A total of 27 artificial right tibias (3 per subgroup) were allocated to 9 experimental groups based on the inclination of the socket tunnels (55°, 60°, and 65°) created for simulating medial and lateral MAT and ACLR. Five standardized socket tunnels were created for each tibia using arthroscopic guides: one for the ACL tibial insertion and one for each meniscus root insertion. CT scans were performed for all specimens and sequentially processed using computer software to produce 3D models for quantitative assessment of socket-tunnel overlap risk. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney U tests.
UNASSIGNED: No subgroup consistently presented significantly safer distances than other subgroups for all distances measured. Three cases (11%) and 24 cases (~90%) of tunnel overlap occurred between the ACL tunnel and tunnels for medial and lateral MAT, respectively. Most socket-tunnel overlap (25 of 27; 92.6%) occurred between sockets at depths ranging between 6.3 and 10 mm from the articular surface. For ACLR and posterior root of the lateral meniscus setting, the guide set at 65° increased socket-tunnel distances.
UNASSIGNED: When combined ACLR and MAT using socket tunnels for graft fixation is performed, the highest risk for tibial socket-tunnel overlap involves the ACLR tibial socket and the lateral meniscus anterior root socket at a depth of 6 to 10 mm from the tibial articular surface.
UNASSIGNED: Setting tibial guides at 65° to the tibial articular surface with the tunnel entry point anteromedial and socket aperture location within the designated anatomic \"footprint\" will minimize the risk for socket-tunnel overlap.
UNASSIGNED: The purpose of this study was to determine optimal socket-tunnel drilling parameters for medial and lateral MAT with concurrent ACLR using artificial tibias and computed tomography (CT) scans for 3-dimensional (3D) modeling. It was hypothesized that clinically relevant socket tunnels could be created to allow for concurrent medial or lateral MAT and ACLR without significant risk for overlap at varying tunnel guide angles.
UNASSIGNED: Descriptive laboratory study.
UNASSIGNED: A total of 27 artificial right tibias (3 per subgroup) were allocated to 9 experimental groups based on the inclination of the socket tunnels (55°, 60°, and 65°) created for simulating medial and lateral MAT and ACLR. Five standardized socket tunnels were created for each tibia using arthroscopic guides: one for the ACL tibial insertion and one for each meniscus root insertion. CT scans were performed for all specimens and sequentially processed using computer software to produce 3D models for quantitative assessment of socket-tunnel overlap risk. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney U tests.
UNASSIGNED: No subgroup consistently presented significantly safer distances than other subgroups for all distances measured. Three cases (11%) and 24 cases (~90%) of tunnel overlap occurred between the ACL tunnel and tunnels for medial and lateral MAT, respectively. Most socket-tunnel overlap (25 of 27; 92.6%) occurred between sockets at depths ranging between 6.3 and 10 mm from the articular surface. For ACLR and posterior root of the lateral meniscus setting, the guide set at 65° increased socket-tunnel distances.
UNASSIGNED: When combined ACLR and MAT using socket tunnels for graft fixation is performed, the highest risk for tibial socket-tunnel overlap involves the ACLR tibial socket and the lateral meniscus anterior root socket at a depth of 6 to 10 mm from the tibial articular surface.
UNASSIGNED: Setting tibial guides at 65° to the tibial articular surface with the tunnel entry point anteromedial and socket aperture location within the designated anatomic \"footprint\" will minimize the risk for socket-tunnel overlap.
摘要：
■半月板同种异体移植（MAT）结合前交叉韧带重建（ACLR）过程中的Socket-tunnel重叠可能会损害移植物的完整性并导致固定受损和治疗失败。
■这项研究的目的是使用人工胫骨和计算机断层扫描（CT）扫描进行3维（3D）建模，确定同时进行ACLR的内侧和外侧MAT的最佳承窝隧道钻孔参数。假设可以创建临床相关的插座隧道，以允许同时进行内侧或外侧MAT和ACLR，而不会在不同的隧道引导角度下出现明显的重叠风险。
■描述性实验室研究。
■根据套节隧道的倾斜度（55°，60°,和65°），用于模拟内侧和外侧MAT和ACLR。使用关节镜引导为每个胫骨创建了五个标准化的插座隧道：一个用于ACL胫骨插入，一个用于每个半月板根部插入。对所有标本进行CT扫描，并使用计算机软件依次处理，以产生3D模型，以定量评估承插隧道重叠风险。用Kruskal-Wallis和Mann-WhitneyU检验进行统计分析。
■对于所有测量的距离，没有一个子组始终比其他子组表现出明显更安全的距离。3例（11％）和24例（〜90％）的隧道重叠发生在ACL隧道与内侧和外侧MAT隧道之间，分别。大多数插座-隧道重叠（27个中的25个；92.6％）发生在距关节表面6.3至10mm的深度之间的插座之间。对于ACLR和外侧半月板设置的后根，设置在65°的引导增加了插座-隧道距离。
■当使用用于移植物固定的承窝隧道进行ACLR和MAT组合时，胫骨窝-隧道重叠的最高风险涉及ACLR胫骨窝和距胫骨关节面6~10mm深度的外侧半月板前根窝.
■将胫骨导向器与胫骨关节表面成65°，使隧道入口点前内侧和窝孔位于指定的解剖结构“覆盖区”内，将最大限度地降低窝-隧道重叠的风险。
■这项研究的目的是使用人工胫骨和计算机断层扫描（CT）扫描进行3维（3D）建模，确定同时进行ACLR的内侧和外侧MAT的最佳承窝隧道钻孔参数。假设可以创建临床相关的插座隧道，以允许同时进行内侧或外侧MAT和ACLR，而不会在不同的隧道引导角度下出现明显的重叠风险。
■描述性实验室研究。
■根据套节隧道的倾斜度（55°，60°,和65°），用于模拟内侧和外侧MAT和ACLR。使用关节镜引导为每个胫骨创建了五个标准化的插座隧道：一个用于ACL胫骨插入，一个用于每个半月板根部插入。对所有标本进行CT扫描，并使用计算机软件依次处理，以产生3D模型，以定量评估承插隧道重叠风险。用Kruskal-Wallis和Mann-WhitneyU检验进行统计分析。
■对于所有测量的距离，没有一个子组始终比其他子组表现出明显更安全的距离。3例（11％）和24例（〜90％）的隧道重叠发生在ACL隧道与内侧和外侧MAT隧道之间，分别。大多数插座-隧道重叠（27个中的25个；92.6％）发生在距关节表面6.3至10mm的深度之间的插座之间。对于ACLR和外侧半月板设置的后根，设置在65°的引导增加了插座-隧道距离。
■当使用用于移植物固定的承窝隧道进行ACLR和MAT组合时，胫骨窝-隧道重叠的最高风险涉及ACLR胫骨窝和距胫骨关节面6~10mm深度的外侧半月板前根窝.
■将胫骨导向器与胫骨关节表面成65°，使隧道入口点前内侧和窝孔位于指定的解剖结构“覆盖区”内，将最大限度地降低窝-隧道重叠的风险。
