The Establish Ment Of Three-dimensional Digital Knee Model And Anatomic Study After ACL Reconstruction

Part.1The clinic assessment of anterior cruciate ligament Single-bundle reconstruction with hamstring tendon autograftObjectiveThe ACL reconstruction under arthroscopy is the main method to treat anterior cruciate ligament injury, so this study reviewed60inpatients who had accepted ACL reconstruction with the hamstring tendon for single-bundle reconstruction in the First Affiliated Hospital of Kunming Medical University from September2009to May2012and observed the early clinic effect of ACL reconstruction with the hamstring tendon single-bundle reconstruction under arthroscopy.Methods1.60patients were selected as study objects who had gotten the hamstring tendon single-bundle reconstruction for the anterior cruciate ligament in the First Affiliated Hospital of Kunming Medical University from September2009to May2012, Included33males,27females,35left knee cases,25right knee cases among which, the youngest inpatient was18-years-old inpatient and46-years-old inpatient in the oldest. In these inpatients, the average age was (36.1±13.5) years. There were not statistic significant at all (P<0.05) among gender, age, left knee and right knee. All of the inpatients used Rigidfix to fix for distal femoral and Intrafix interface screws in tibial. All of these operations were finished by a experienced doctor. After1-36months operation, The patients were evaluated with Lysholm score and IKDC score, drawer tests and Lachman tests and evaluated the clinic effects of autograft hamstring tendon single-bundle reconstruction. 2. SPSS17.0statistical software was used to analysed the data, all of which was expressed by (X±S). The preoperative and postoperative with evaluation Lysholm and IKDC, The standards of evaluation were compared with paired T test, P<0.05was considered statistically significant. Preoperative and postoperative drawer test and Lachman test were compared with X2test. P<0.05was considered statistically significance.Results1. All the inpatients were normal with extending knee or bending knee except2patients limited to extend knee range form5°to15°and five inpatients limited to extend knee range form10°to15°.2. Among follow-up visited60inpatients, there were57cases were negative Lachman test and3inpatients were positive Lachman test, there were58inpatients, were negative and2inpatients were positive by drawer test, there were58inpatients.58cases had some distinct patients difference from preoperative and postoperative (P <0.05). It certified that the function of knee after operation was abviously more stable than preoperation.ConclusionThe part of this study had showed that arthroscopic Autograft hamstring tendon single-bundle anterior cruciate ligament reconstruction was a reliable method to treat anterior cruciate ligament injury. The function of knee of all the patients had been well the same as normal person. It proved that Autograft with hamstring tendon single-bundle reconstructive for the anterior cruciate ligament could applied in clinic filed.Part2. Establish ment of three-dimensional digital knee model after ACL reconstruction based two-dimensional MRI image and anatomic evaluationObjectiveThis study based on two-dimensional MRI images of natural adults knee and patients who had operated with single-bundle ACL reconstructed the three-dimensional digital model. To explore the digital anatomy between the normal adult ACL and single-bundle reconstructed ACL with the autograft hamstring tendon.Methods1.20inpatients were selected from the first part which followed-up. The had been operated with sing-bundle anterior cruciate ligament reconstructed. These knee were scanned with two-dimensional MRI and obtained data with images continuous and thickness was1.0mm. The data were imported into computer with pattern of DICOM, then rebuilt digitial knee model which included distal femur, proximal tibia, ACL, PCL, knee meniscus patella and fibula. Finally, these indexes were measured by software measurement which was regarded as the postoperative group of reconstructed ACL.2.20adult volunteers natual knees were scanned by2-D MRI and images were gotten with continuous and their thickness was1.0mm. The images were imported into computer to rebuild a3-D knee. The three-dimensional model also included distal femur, ACL, PCL, knee meniscus patella and fibula. Finally, their various indexes were measured by software measurement. Which were considered as the normal adult model group.3. All of the data were analysed by statistic software SPSS17.0and showed by mean±standard deviation.Between two groups of various indexes compared with each other and analysed with T test, a=0.05was regard as standard duration. P<0.05was the statistic significance.ResultsThe ACL-related digital indicator between ACL postoperative reconstructed model group and normal model group, Sagittal ACL angle(y angle), ACL length(point H to I). Coronal ACL angle(β angle), Horizonta postoperative1position ACL angle (a angle),The distance from ACL leading edge to tibia platform (point G to F), The distance from ACL to inner side tibia platform inner edge (point G to E), Intercondylar notch width(point A to B), The distance ACL from the over-top of intercondylar fossa (point O to C), ACL distance away from the lateral wall of the intercondylar notch(point O to D). Which there was no significant,(P>0.05).Conclusion1. The three dimensional digital model after ACL reconstruction was software successfully established through MIMICS10.01.2. The three-dimensional model reconstruction for the clinical assessment provided an alternative reliable method.3. Anterior Cruciate Ligament Single-bundle Reconstruction with Hamstring Tendon Autograft had ment the anatomic reconstruction. Anterior Cruciate Ligament Single-bundle reconstruction with Hamstring Tendon Autograft was worthy for clinical application.