30. Clinical outcomes of single-bundle anterior cruciate ligament reconstruction guided by the footprint center from the intact contralateral knee
Main Article Content
Abstract
Three-dimensional magnetic resonance imaging (3D MRI) of the healthy knee can assist surgeons in identifying key anatomical parameters of the anterior cruciate ligament (ACL), supporting precise surgical planning and intraoperative control through imaging guidance. We conducted a longitudinal study on 45 patients with unilateral ACL tears who underwent single-bundle ACL reconstruction using all-inside technique based on 3D MRI measurements from the contralateral healthy knee. Preoperative and postoperative parameters were compared, and clinical outcomes were evaluated. Results showed no significant difference between the ACL’s footprint position and length on 3D MRI and ACL graft’ tunnel position and length on postoperative computed tomography (CT) scans. Clinically, knee stability, functional scores, and activity levels improved significantly postoperatively. This study suggests that single-bundle ACL reconstruction guided by anatomical parameters from 3D MRI of the healthy knee provides favorable imaging and clinical outcomes. We suggest further studies to reinforced the value and efficacy of this novel approach.
Article Details
Keywords
Anterior cruciate ligament, ACL, 3D magnetic resonance imaging, single-bundle
References
2. Alomari MS, Ghaddaf AA, Abdulhamid AS, Alshehri MS, Ashraf M, Alharbi HH. Single Bundle Versus Double Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Indian J Orthop 2022; 56(10): 1669-84.
3. van Eck CF, Widhalm H, Murawski C, Fu FH. Individualized anatomic anterior cruciate ligament reconstruction. Phys Sportsmed 2015; 43(1): 87-92.
4. Shen X, Qin Y, Zuo J, Liu T, Xiao J. A Systematic Review of Risk Factors for Anterior Cruciate Ligament Reconstruction Failure. Int J Sports Med 2021; 42(8): 682-93.
5. Robinson J, Inderhaug E, Harlem T, Spalding T, Brown CH, Jr. Anterior Cruciate Ligament Femoral Tunnel Placement: An Analysis of the Intended Versus Achieved Position for 221 International High-Volume ACL Surgeons. Am J Sports Med 2020; 48(5): 1088-99.
6. Vũ Tú Nam, Võ Sỹ Quyền Năng, Phạm Trung Hiếu et al. Location of the Anatomic Footprint Centers of the Anterior Cruciate Ligament Determined by Quadrant Method on Three-Dimensional Magnetic Resonance Imaging. Indian J Orthop 2024; 58(11): 1650-6.
7. Parkinson B, Gogna R, Robb C, Thompson P, Spalding T. Anatomic ACL reconstruction: the normal central tibial footprint position and a standardised technique for measuring tibial tunnel location on 3D CT. Knee Surg Sports Traumatol Arthrosc 2017; 25(5): 1568-75.
8. Hart A, Sivakumaran T, Burman M, Powell T, Martineau PA. A Prospective Evaluation of Femoral Tunnel Placement for Anatomic Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Magnetic Resonance Imaging. Am J Sports Med 2018; 46(1): 192-9.
9. Xu H, Zhang C, Zhang Q, et al. A Systematic Review of Anterior Cruciate Ligament Femoral Footprint Location Evaluated by Quadrant Method for Single-Bundle and Double-Bundle Anatomic Reconstruction. Arthroscopy 2016; 32(8): 1724-34.
10. Nguyễn Thị Hồng Yến, Nguyễn Văn Hoạt, Ngô Xuân Khoa, và cộng sự. Giải phẫu dây chằng chéo trước trên phim cộng hưởng từ. Tạp chí Y học Việt Nam 2019; 483 (Tháng 10, số 2): 24-7.
11. Trần Quốc Lâm. Nghiên cứu giải phẫu và đối chiếu trong phẫu thuật nội soi tái tạo dây chằng chéo trước khớp gối bằng kỹ thuật một bố tất cả bên trong. Hà Nội: Đại học Y Hà Nội; 2018.
12. Dương Đình Toàn, Nguyễn Trọng Toàn. Kết quả phẫu thuật nội soi tái tạo dây chằng chéo trước bằng kỹ thuật All-inside sử dụng mảnh ghép gân hamstring tự thân. Tạp chí Y học Việt Nam 2021; 504(2).
13. Schurz M, Tiefenboeck TM, Winnisch M, et al. Clinical and Functional Outcome of All-Inside Anterior Cruciate Ligament Reconstruction at a Minimum of 2 Years’ Follow-up. Arthroscopy 2016; 32(2): 332-7.
14. Trương Trí Hữu, Lê Quang Tuấn. Đánh giá kết quả lâm sàng phẫu thuật nội soi tái tạo dây chằng chéo trước bằng kỹ thuật “tất cả bên trong”. Y Học TP Hồ Chí Minh 2019; (3): 49-54.
15. Lubowitz JH, Schwartzberg R, Smith P. Randomized Controlled Trial Comparing All-Inside Anterior Cruciate Ligament Reconstruction Technique With Anterior Cruciate Ligament Reconstruction With a Full Tibial Tunnel. Arthroscopy: The Journal of Arthroscopic & Related Surgery 2013; 29(7): 1195-200.