Effects of graft pretensioning in anterior cruciate ligament reconstruction
Effects of graft pretensioning in anterior cruciate ligament reconstruction
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DOI：
10.1007/s00167-011-1833-1
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发表时间：
2012-11-01
影响因子：
3.8
通讯作者：
Robert, Henri
中科院分区：
文献类型：
--
作者：
Guillard, Claude;Lintz, Francois;Robert, Henri
移植物预张用于前交叉韧带（ACL）重建以防止继发性松弛。其对胶原纤维超微结构的影响尚不清楚。在这项研究中，我们假设，移植物预张在ACL重建创建扫描电子显微镜（SEM）检测到的超微结构的变化。一个前瞻性的比较研究进行了38 ACL重建使用4股半腱肌移植。在预拉伸30 s、2或5 min前后，术中采集样本。使用原始半定量A >评分分析SEM中生成的图像，同时考虑胶原的凝聚力、完整性和平行性。对CIP评分的测试者内和测试者间信度进行了检验，预张后CIP评分下降了3.5（1.6）分（P < 0.05）。5、2 min和30 s亚组的总体CIP评分存在显著差异。与30 s亚组相比，预张后2和5 min亚组的相对降低（Δ CIP）显著更高。CIP评分的测试者内和测试者间信度分别为0.85和0.92（P < 0.05）。这些结果证实了存在的胶原超微结构的变化后，预拉伸，可能与其持续时间。
Graft pretensioning is used in anterior cruciate ligament (ACL) reconstruction to prevent secondary slackening. Its effects on collagen fibrillar ultrastructure are not known. In this study, we hypothesized that graft pretensioning in ACL reconstruction creates ultrastructural changes detectable in scanning electron microscopy (SEM).A prospective comparative study was carried out on 38 ACL reconstructions using a 4-strand semitendinosus graft. Samples were harvested intra-operatively before and after pretensioning for 30 s, 2 or 5 min. The images produced in SEM were analyzed using an original semi-quantitative A > score taking into account collagen cohesion, integrity, and parallelism. Intra- and inter-tester reliability for the CIP score were tested.The CIP scores decreased by 3.5 (1.6) points after pretensioning (P < 0.05). Significant differences were found in the 5, 2 min and 30 s subgroups for the global CIP score. Relative decrease (Delta CIP) was significantly higher in the 2 and 5 min subgroups after pretensioning in comparison with the 30 s subgroups. Intra- and inter-tester reliability for the CIP score were 0.85 and 0.92 (P < 0.05).Pretensioning ACL grafts resulted in alteration of the collagen fibrillar ultrastructure, detectable using SEM. These results confirm the existence of collagen ultrastructural changes after pretensioning that may be related to its duration.Prospective comparative study, Level II.