Tunnel Overlap Occurs 25% of the Time With Simultaneous Anterior Cruciate Ligament Reconstruction and Lateral Meniscal Root Repair

Steven DeFroda M.D., M.Eng. , João Bourbon de Albuquerque II M.D., M.B.A., M.Sc., Ph.D. , Will Bezold B.S. , Cristi R. Cook D.V.M. , Clayton W. Nuelle M.D. , James P. Stannard M.D. , James L. Cook D.V.M., Ph.D.
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Abstract

Purpose

To assess the risk of socket-tunnel overlap for posterior medial or lateral meniscal root repair combined with anterior cruciate ligament reconstruction (ACLR) using artificial tibias and computed tomography scans for 3-dimensional modeling.

Methods

Artificial tibias (n = 27; n = 3/subgroup) were allocated to groups based on inclination of socket-tunnels (55°, 60°, 65°) created for posterior root of the medial meniscus (MMPR) and lateral meniscus posterior root (LMPR) repair, and ACLR. Three standardized socket-tunnels were created: one for the ACL and one for each posterior meniscal root insertion. Computed tomography scans were performed and sequentially processed using computer software to produce 3-dimensional models for assessment of socket-tunnel overlap. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney U tests. Significance was set at P < .05.

Results

The present study found no significant risk of tunnel overlap when drilling for combined ACLR and MMPR repair, whereas 7 cases of tunnel overlap occurred between ACL tunnels and LMPR (25.9% of cases). No subgroup or specific pattern of angulation consistently presented significantly safer distances than other subgroups for all distances measured.

Conclusions

This study demonstrated 25.9% rate of overlap for combined LMPR repair and ACLR, compared with 0% for MMPR repair with ACLR. Lower ACL drilling angle (55 or 60°) combined with greater lateral meniscus drilling angle (65°) produced no socket-tunnel overlap.

Clinical Relevance

Socket-tunnel overlap during meniscal root repair combined with ACLR may compromise graft integrity and lead to impaired fixation and treatment failure of either the ACL, the meniscus, or both. Despite this, risk for socket-tunnel overlap has not been well characterized.

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同时进行前交叉韧带重建和外侧 2 半月板根部修复时,隧道重叠发生率为 25
目的使用人工胫骨和计算机断层扫描进行三维建模,评估后内侧或外侧半月板根部修复联合前交叉韧带重建术(ACLR)出现套筒-隧道重叠的风险。方法根据为内侧半月板后根(MMPR)和外侧半月板后根(LMPR)修复以及前交叉韧带重建创建的套筒隧道的倾斜度(55°、60°、65°),将人工胫骨(n = 27;n = 3/子组)分配到各组。创建了三个标准化套筒隧道:一个用于前交叉韧带,另一个用于半月板后根插入。进行计算机断层扫描并使用计算机软件按顺序处理,以生成三维模型,用于评估套筒-隧道重叠情况。统计分析采用 Kruskal-Wallis 和 Mann-Whitney U 检验。结果本研究发现,在联合 ACLR 和 MMPR 修复钻孔时,隧道重叠的风险并不显著,而在 ACL 隧道和 LMPR 之间发生隧道重叠的病例有 7 例(占病例总数的 25.9%)。在测量的所有距离中,没有任何亚组或特定角度模式的距离明显比其他亚组安全。较小的前交叉韧带钻孔角度(55 或 60°)加上较大的外侧半月板钻孔角度(65°)不会产生套筒-隧道重叠。尽管如此,承插口-隧道重叠的风险还没有得到很好的描述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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