前交叉韧带重建术中胫骨隧道位置对外侧半月板半脱位的影响研究

The Effect of the Position of the Tibial Tunnel on the Lateral Meniscus Subluxation During Anterior Cruciate Ligament Reconstruction

目的探究前交叉韧带重建术中胫骨隧道位置对外侧半月板半脱位的影响。方法该研究随机选取2018年5月—2019年5月期间该院广东省中山市中医院接受膝关节相关手术治疗的患者50例作为研究对象,术前征求患者本人或其家属同意;术前详细记录患者的个人资料、病史、体征以及相关影像学资料;术前ACL损伤以患者症状、体征及MRI检查结果为依据,术中行ACL损伤探查以进一步明确诊断。结果Spearman相关性结果表明,RTD和LMSV的相关性(r=-0.826,P<0.05),提示胫骨隧道到外侧沟距离过少容易并发术后LM半脱位。绘制ROC曲线,找出其约登指数,最小化的“最优”RTD值分别对应的灵敏度和特异度为94.7%、83.6%。曼-惠特尼U检验计算得出差异无统计学意义的RTD值区间范围为8.8~13.5 mm。结论胫骨隧道到外侧沟距离过少容易并发术后LM半脱位。

Objective To investigate the effect of tibial tunnel position on lateral meniscus subluxation during anterior cruciate ligament reconstruction.Methods In this study,from May 2018 to May 2019,50 patients who underwent knee joint surgery in Zhongshan City,Guangdong Province,were convenient selection used as the research object,and seek the consent of the patient or his family before the operation;detailed records of the patient's personal information,medical history,signs and related imaging information before the operation;preoperative ACL damage based on the symptoms,signs and MRI examination results,ACL injury exploration was performed during operation to further confirm the diagnosis.Results Spearman correlation results showed that the correlation between RTD and LMSV(r=-0.826,P<0.05),suggesting that too little distance from the tibial tunnel to the lateral sulcus is likely to cause postoperative LM subluxation.Draw the ROC curve,find out its Youden index,and the minimum“optimal”RTD value corresponds to a sensitivity and specificity of 94.7%and 83.6%,respectively.The Mann-Whitney U test calculated that the range of RTD values with no statistical difference was 8.8-13.5 mm.Conclusion Too little distance from the tibial tunnel to the lateral sulcus can easily lead to postoperative LM subluxation.