genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2025-31-5-567-573genort-3329Research ArticleОригинальные статьиOriginal articlesРеконструкция передней крестообразной связки: корреляция функционального результата с положением бедренного и большеберцового каналовACL reconstruction: correlation of the functional outcome with the position of femoral and tibial tunnelshttps://orcid.org/0000-0002-4091-9447ShindeM. B.ShindeM. B.

Mumbai

Mahesh B Shinde — Senior resident

Mumbai

mahesh.shinde.1466@gmail.comhttps://orcid.org/0000-0001-6304-5845PatelM. R.PatelM. R.

Mumbai

Mihir R Patel — Additional Professor

Mumbai

mrpatel1981@gmail.comhttps://orcid.org/0009-0000-3805-2445SarweyK.SarweyK.

Mumbai

Kshitij Sarwey — Junior Resident

Mumbai

kshitijsarwey@gmail.comhttps://orcid.org/0009-0009-2745-4241JethliaS.JethliaS.

Mumbai

Sanket Jethlia — Junior Resident

Mumbai

sanketjethliya1@gmail.comhttps://orcid.org/0009-0003-0034-6925KaulgudV.KaulgudV.

Mumbai

Ved Kaulgud — Medical student

Mumbai

ved.kaulgud@gmail.comhttps://orcid.org/0009-0006-7032-0829DattaR.DattaR.

Mumbai

Renema Datta — Medical student

Mumbai

dattarenema@gmail.comhttps://orcid.org/0009-0001-3138-8824ModiA.ModiA.

Mumbai

Arnav Modi — Medical student

Mumbai

modiarnav17@gmail.comhttps://orcid.org/0009-0001-5698-7110KharateS.KharateS.

Mumbai

Sushrut Kharate — Medical student

Mumbai

sushkharate@gmail.comhttps://orcid.org/0009-0004-5200-4270SinghS.SinghS.

Mumbai

Sukanya Singh — Medical student

Mumbai

sukanyasinghh2004@gmail.comhttps://orcid.org/0009-0000-4167-4309BopardikarT.BopardikarT.

Mumbai

Tej Bopardikar — Medical student

Mumbai

tejbopardikar@gmail.comhttps://orcid.org/0009-0004-8122-3181BeniwalV.BeniwalV.

Mumbai

Vanshika Beniwal — Medical student

Mumbai

vanshikaabeniwal@gmail.comhttps://orcid.org/0009-0008-2292-3312ChiwadshettiSh.ChiwadshettiSh.

Mumbai

Shreyasi Chiwadshetti — Medical student

Mumbai

chiwadshetti.s@gmail.comHBT Medical College and Dr. RN Cooper Hospital JuhuИндияHBT Medical College and Dr. RN Cooper Hospital JuhuIndia202521102025315567573Copyright © Shinde M.B., Patel M.R., Sarwey K., Jethlia S., Kaulgud V., Datta R., Modi A., Kharate S., Singh S., Bopardikar T., Beniwal V., Chiwadshetti S., 20252025Shinde M.B., Patel M.R., Sarwey K., Jethlia S., Kaulgud V., Datta R., Modi A., Kharate S., Singh S., Bopardikar T., Beniwal V., Chiwadshetti S.Shinde M.B., Patel M.R., Sarwey K., Jethlia S., Kaulgud V., Datta R., Modi A., Kharate S., Singh S., Bopardikar T., Beniwal V., Chiwadshetti S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/3329Введение

Введение. Передняя крестообразная связка (ПКС) является основной связкой, стабилизирующей колено и предотвращающей смещение голени вперед. Ее роль существенна в механизме винтовой фиксации, который помогает противостоять вальгусной и ротационной нагрузкам. Однопучковая артроскопическая аутопластика считается «золотым стандартом» при реконструкции ПКС, в результате которой стабилизируется сустав и предотвращается дегенерация хряща. Отрицательные результаты часто вызваны техническими ошибками во время операции, такими как неправильное положение канала для трансплантата.

Цель работы — сравнительная оценка функциональных результатов у пациентов с реконструкцией ПКС при помещении трансплантата в анатомическое и неанатомическое положения.

Материал и методы

Материал и методы. Данное 24-месячное перспективное наблюдательное исследование проведено на 44 пациентах, которым выполняли артроскопическую реконструкцию ПКС и послеоперационное КТ-исследование. Пациенты разделены на две группы: группа с анатомическим положением трансплантата (30 пациентов) и группа с неанатомическим положением трансплантата (14 пациентов). Наиболее распространенным видом травмы была спортивная травма. Для функциональной оценки при контроле через три, шесть и 12 месяцев использовали оценочную шкалу Lysholm.

Результаты

Результаты. Средний балл по Lysholm до операции составил 41,24 для всей выборки. В анатомической группе общий балл улучшился до 80,91 через три месяца, до 85,91 через шесть месяцев и до 89,23 через двенадцать месяцев. В неанатомической группе показатели составили соответственно: 58,58, 65,13 и 58,58 баллов. Улучшение суммы баллов по шкале Lysholm в анатомической группе было статистически значимым. Заключение. Артроскопическая реконструкция ПКС имеет лучший функциональный результат при  помещении трансплантата в анатомическое положение по сравнению с неанатомическим положением.

Introduction The anterior cruciate ligament (ACL) is the main ligament that stabilizes the knee and stops anterior translation. It is also essential to the screw-home mechanism and helps resist valgus and rotational stress. For ACL reconstruction, autograft arthroscopic single-bundle surgery is regarded as the "gold standard" procedure. Joint laxity is enhanced and cartilage degradation is avoided with anatomical ACL restoration. Negative results are frequently caused by technical surgical errors, such as improper tunnel placement.

This study aims to evaluate the functional outcome in ACL-reconstructed patients when a graft is placed in an anatomical position, as well as to compare it with when a graft is placed in a non-anatomical place.

Methodology This is a 24-month prospective observational study conducted on 44 patients who underwent arthroscopic ACL reconstruction, with post-op CT scans performed after permission from the institutional review board (IRB). The most common mode of injury was sports-related. Thirty patients belonged to the  anatomical group, and 14 patients belonged to the non-anatomical group based on inclusion and exclusion criteria. The Lysholm scoring system was used for functional evaluation on follow-up at three, six, and 12 months.

Results The mean Lysholm score was 41.24 before surgery for the entire sample. In the anatomical group, the score improved to 80.91 at three months, 85.91 at six months, and 89.23 at twelve months. In the non‑anatomical group, the score was 58.58 at three months, 65.13 at six months, and 58.58 at twelve months. The improvement in Lysholm scores in the anatomical group was statistically significant.

Conclusion This study concludes that the functional outcome of ACL reconstruction is better when the graft is placed in anatomical footprints than when it is placed in non-anatomical footprints.

бедренный каналбольшеберцовый каналреконструкция ПКСанатомическая трансплантацияоценка LysholmFemoral tunneltibial tunnelACL reconstructionanatomical graftingLysholm scoreNone.ReferencesSanders TL, Maradit Kremers H, Bryan AJ, et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016;44(6):1502-1507. doi: 10.1177/0363546516629944.Sanders TL, Maradit Kremers H, Bryan AJ, et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016;44(6):1502-1507. doi: 10.1177/0363546516629944.Chahla J, Moatshe G, Cinque ME, et al. Arthroscopic Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: Pearls for an Accurate Reconstruction. Arthrosc Tech. 2017;6(4):e1159-e1167. doi: 10.1016/j.eats.2017.04.001.Chahla J, Moatshe G, Cinque ME, et al. 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The authors declare that there are no conflicts of interest present.