SO SÁNH KÍCH THƯỚC DIỆN BÁM MÂM CHÀY CỦA DÂY CHẰNG CHÉO TRƯỚC TRÊN MRI VÀ THỰC TẾ

Abstract

Background: Anterior cruciate ligament (ACL) injury significantly affects the anatomical and functional aspects of the knee joint. Currently, with more and more laparoscopic knee ACL reconstruction, surgeons want to optimize the ligament reconstruction individually for better results to the patient. Recent studies have shown that there are advantages for the two-bundle ACL reconstruction technique in comparison with the single-bundle reconstruction technique. For this technique, determining the anteroposterior diameter of the tibial plateau attachment area is necessary, but it is difficult to determine intraoperatively. Therefore, shaping the dimensions of the ACL on the tibial plateau is necessary and beneficial for planning before surgery. Objective: To investigate the size of the anterior posterior diameter and the lateral diameter of the tibial plateau attachment of the anterior cruciate ligament on MRI and through knee arthroscopy then compare with each other. Subjects: Patients were indicated for endoscopic reconstruction of ACL at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City and Military Hospital 7A. Method: Descriptive cross-sectional method was used. Measurements of dimensions on MRI were surveyed through software at the hospital's imaging department. Measurements in arthroscopic knee surgery are performed by using a specialized ruler then capturing the  image by arthroscope, the images are then processing with Google Sketchup 2021 software. Results: In 30 surveyed cases (24 men, 6 women), all were measured the size of the anterior posterior diameter and the lateral diameter of the tibial plateau attachment of the anterior cruciate ligament on MRI and through knee arthroscopy. The anteroposterior diameter of the tibial plateau on MRI is 15.3 ± 1.2 mm, of which the anteroposterior diameter in men is 15.53 ± 1.2 mm and in women is 14.45 ± 0.6 mm. The lateral diameter of tibial plateau attachment on MRI 10.1 ± 1.1 mm, the lateral diameter of tibial plateau attachment on knee arthroscopy is 10.2 ± 1.2 mm in men and 9.7 ± 0.9 mm in women. The anterior and posterior diameter of tibial plateau attachment on knee arthroscopy is 15.3 ± 1.2 mm, the anterior and posterior diameter of tibial plateau attachment on knee arthroscopy is 15.5 ± 1.2 mm and in women is 14.4 ± 0.8 mm. The diameter of the tibial plateau attachment surface on knee arthroscopy is 10.6 ± 1.1 mm, in which the diameter of the tibial plateau attachment surface on knee arthroscopy is 10.7 ± 1.1 mm in men and 9.8 ± 0.9 mm in women. The study results also showed a correlation between the size measured on MRI and through knee arthroscopy according to the linear regression process: Actual before – after length (mm) = 2.018 + 0.863 x (before – after MR length) [mm]), actual lateral length (mm) = 3.225 + 0.727 x (MRI lateral length [mm]). Conclusion: The research results partly help orthopedic surgeons can be more proactive in choosing grafts based on the results of knee MRI in knee ACL reconstruction surgery.