Akademik Veri Yönetim Sistemi
ISHA Congres 2022, Glasgow, İngiltere, 13 - 15 Ekim 2022, cilt.3, ss.13, (Özet Bildiri)
Purpose: Suture anchors are used to fix torn labrum to the acetabular rim. The safe anchor insertion angle is an anatomic measurement that is indicative of the safety margin for inserting suture anchors. Using reference line to obtain a safe anchor insertion angle could facilitate to insert the anchor in the bony acetabular vault and prevent the anchor penetration. The purpose of the presented study is to demonstrate the usefulness of the reference line which is drawn perpendicular to the acetabular opening plane. Further purpose is to obtain a safe anchor insertion angle that will facilitate to purchase the suture anchor in the bony acetabular vault and prevent the anchor penetration.
Methods: Randomly, retrospectively chosen computed tomography scans of 100 hip specimens used to reconstruct 3-dimensional acetabular hip models. Each model radially sectioned at 4-o’clock, 3-o’clock, and the anterior inferior iliac spine (AIIS) corresponded mostly to the 2.20 clock position. At each position of acetabular models, the perpendicular reference line was drawn and its relation to the safe acetabular rim angle was measured. In the scenario-1, the perpendicular reference line was located in the safe acetabular rim angle. Otherwise, acetabular models were noted as scenario-2. The length of the perpendicular reference line and the effect of gender on measurements were also evaluated.
Results: The perpendicular reference line remained in the safe acetabular rim angle in all cases at the AIIS position. 28 cases fitted in scenario-2, mostly in female acetabula at the 3-o’clock position. The length of the perpendicular reference line was shorter in female acetabula (P < 0.001) and, was the shortest at the 3-o’clock position. The safe acetabular rim angle was smallest at the 3-o’clock position and was smaller in Scenario-2 acetabula.
Conclusion: Aligning the drill bit perpendicular to the acetabular opening plane during arthroscopic anchor placement is a practical way to estimate and target the position of the safe acetabular rim angle to avoid anchor perforations. Based on measurements from a perpendicularly aligned drill bit, the drill bit should be directed toward the joint minimally 4° to avoid extra-articular perforations and maximally 30° to avoid intra-articular perforations.