前交叉韧带重建术后残留轻度旋转不稳的风险因素分析

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Abstract Objective To identify the risk factors of mild rotational instability after anterior cruciate ligament (ACL) reconstruction in short term.Methods The data patients undergoing ACL reconstruction from January 2015 to January 2018 were retrospectively reviewed.Based on the result of pivot shift test in the last follow-up，a total of 22 patients with grade Ⅰ pivot shift test were included in the study group，24 patients with negative pivot shift test were included in the control group.Firstly，the age，gender，BMI，time from injury to surgery，diameter of graft，combined lateral/medial meniscal lesions，distance from tunnel central point to IDEAL point on CT，quadriceps to hamstring Ratio of maximum strength were compared between the two groups using student t test and chi-square test.Secondly，logistic regression was used to analyze the relationship between two groups，in order to identify the risk factors of residual mild rotational instability after ACL reconstruction.Results There were statistically significant differences between two groups in distance from femoral tunnel central point to IDEAL point on CT(P＝0.004) and quadriceps to hamstring Ratio of maximum strength(P＝0.042).Logistic regression showed that the distance from femoral tunnel central point to IDEAL point on CT(OR=1.18，95%CI：1.04~1.33) and quadriceps to hamstring Ratio of maximum strength (OR=6.65，95%CI：1.13~39.26) are the risk factors of residual mild rotational instability.Conclusion The predictors of residual mild rotational instability after ACL reconstruction included the distance from femoral tunnel central point to IDEAL point on CT and quadriceps to hamstring ratio of maximum strength.The author suggests that intraoperative fluoroscopy could be a safe and easy way to use on the accuracy of femoral tunnel placement in ACL reconstruction.Higher level of hamstring function should be protective of ACL，and improved post ACL reconstruction.

Key words： anterior cruciate ligament reconstruction rotational instability pivot shift risk factor

Fund:国家重点研发计划项目(2019YFF0301703-3)

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