Commercially Available Guides Overestimate Socket Length During Anterior and Posterior Cruciate Ligament Socket Retrograde Drilling.

Autor:	McDermott ER; Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, Texas, U.S.A., Proffitt M; Department of Orthopaedics, Burkhart Research Institute for Orthopaedics, San Antonio, Texas, U.S.A., Nuelle CW; Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A., Balldin BC; Department of Orthopaedics, Burkhart Research Institute for Orthopaedics, San Antonio, Texas, U.S.A.
Jazyk:	angličtina
Zdroj:	Arthroscopy, sports medicine, and rehabilitation [Arthrosc Sports Med Rehabil] 2024 Jul 23; Vol. 6 (4), pp. 100913. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2024).
DOI:	10.1016/j.asmr.2024.100913
Abstrakt:	Purpose: To objectively assess the accuracy of socket measurements taken during cruciate ligament reconstruction using a retrograde reaming technique. Methods: Six complete knee sawbone specimens were used to ream anterior and posterior cruciate ligament sockets in the femur and tibia in a retrograde fashion using a standard retrograde reaming device. The longest and shortest sides of the sockets were measured using a ruler. One-sided Wilcoxon signed-rank sum tests were used to evaluate whether the actual measured socket length matched the estimated length set on the drill guide. Results: One fellowship-trained surgeon reamed 24 total sockets in sawbone specimens using guides. Statistical analysis revealed a significant difference between the estimated measurement and the actual shortest tunnel length in each of the sockets. The median short side socket lengths were shorter than their respective intended depths by 4 mm for the femoral anterior cruciate ligament socket, 6 mm for the femoral posterior cruciate ligament socket, 6 mm for the tibial anterior cruciate ligament socket, and 4.5 mm for the tibial posterior cruciate ligament socket. All differences were significant at α = 0.05. Conclusions: The estimated cruciate socket lengths reamed during ligament reconstruction using a retrograde reamer and standard intra-articular measuring instrumentation were greater than the actual measured socket lengths. Clinical Relevance: Successful cruciate ligament reconstruction relies on accurate socket measurements. This study examined the accuracy of commercially available cruciate ligament socket drill guides and the implications for clinical practice, to include graft-tunnel mismatch and surface area available for healing. Surgeons may consider reaming slightly longer than estimated sockets when performing all-inside cruciate ligament reconstructions to ensure appropriate socket depth for graft fixation. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: E.R.M. reports a relationship with the 10.13039/100008542Arthroscopy Association of North America that includes board/committee membership and a spouse who is employed by Arthex. C.W.N. reports a relationship with the 10.13039/100008542Arthroscopy Association of North America, 10.13039/100009885American Academy of Orthopaedic Surgeons, and 10.13039/100011549American Orthopaedic Society for Sports Medicine that includes board membership and a consulting or advisory role with 10.13039/100007307Arthrex and Vericel Corporation. B.C.B. reports a relationship with the Texas Orthopaedic Association that includes board membership and a consulting or advisory role with 10.13039/100008894Stryker Orthopaedics. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of Defense or the U.S. government. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The other author (M.P.) declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Databáze:	MEDLINE
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