Magnetic resonance imaging analysis of bioabsorbable interference screws used for fixation of bone-patellar tendon-bone autografts in endoscopic reconstruction of the anterior cruciate ligament
Magnetic resonance imaging analysis of bioabsorbable interference screws used for fixation of bone-patellar tendon-bone autografts in endoscopic reconstruction of the anterior cruciate ligament
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DOI：
10.1177/0363546505285384
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发表时间：
2006-07-01
影响因子：
4.8
通讯作者：
Myhr, G
中科院分区：
文献类型：
--
作者：
Drogset, JO;Grontvedt, T;Myhr, G
背景：如果需要翻修，金属干扰螺钉可能会引起问题，并可能干扰磁共振成像。为了预防这些问题，生物可吸收螺钉已经被开发出来，但其吸收和融合率还没有得到很好的了解。假设：前十字韧带重建后2年，聚L乳酸干扰螺钉将被重新吸收。研究设计：病例系列，证据水平，4。方法：研究组19例，采用鼻内窥镜技术，应用自体骨-髌腱-骨移植固定的聚L-乳酸干扰螺钉重建前交叉韧带。结果：术后2年股骨螺钉体积平均缩小%，胫骨螺钉平均缩小63%。股骨块骨性融合良好17例，一般2例。16例患者胫骨骨块融合良好，1例胫骨隧道增宽，患者胫骨融合良好。股骨3例，胫骨无1例发生螺钉周围骨溶解。结论：经磁共振成像测量，术后2年，聚乳酸-L螺钉的平均体积缩小约三分之二。90%的患者骨块融合良好。16%的患者可见螺钉周围的骨溶解。临床意义：在使用聚L-乳酸干扰螺钉重建前交叉韧带两年后，外科医生有望找到大约三分之一的螺钉体积残留在骨隧道中。
Background: Metal interference screws can cause problems if revision is needed and can interfere with magnetic resonance imaging. Bioabsorbable screws have been developed to prevent these problems, but the rate of resorption and integration is not well understood.Hypothesis: Poly-L-lactic acid interference screws will be resorbed 2 years after anterior cruciate ligament reconstruction.Study Design: Case series; Level of evidence, 4.Methods: The study group consisted of 19 patients with isolated anterior cruciate ligament ruptures reconstructed with bone-patellar tendon-bone autografts fixed with poly-L-lactic acid interference screws using an endoscopic technique. Magnetic resonance imaging was used to evaluate resorption of the screws, bony integration of the screws, and integration of the bone blocks after 2 years.Results: At 2 years, the mean reduction in the volume of the femoral screws was 64% and of the tibial screw was 63%. Bony integration of the femoral bone block was considered good in 17 patients and fair in 2 patients. Integration of the tibial bone block was considered good in 16 patients and fair in 1 patient who demonstrated widening of the tibial tunnel. Osteolysis around the screws was seen in 3 patients in the femur and none in the tibia.Conclusion: The mean reduction in volume of the poly-L-lactic acid screws as measured by magnetic resonance imaging after 2 years was approximately two thirds. The integration of the bone blocks was considered good in 90% of the patients. Osteolysis around the screws was visible in 16% of the patients.Clinical Relevance: Two years after ACL reconstruction using poly-L-lactic acid interference screws, the surgeon can expect to find approximately one third of the volume of the screw remaining in the bone tunnels.