Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft
Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft
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DOI：
10.1053/jars.2001.21509
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发表时间：
2001-02-01
影响因子：
4.7
通讯作者：
Rieger, M
中科院分区：
文献类型：
--
作者：
Fink, C;Zapp, M;Rieger, M
目的：本研究的目的是前瞻性评估内窥镜下自体髌腱重建前交叉韧带（ACL）后胫骨隧道的变化。我们使用计算机断层扫描（CT）连续监测2年期间这些变化的时间过程，并将结果与临床结果和仪器松弛测量相关联。研究类型：案例系列。方法：34例患者（11名女性，23名男性，平均年龄26.4±4.5岁）接受了内镜髌腱前交叉韧带重建，根据IKDC， Lysholm和Tegner评分以及2年内胫骨隧道形态学的变化进行临床评估。术后1周、6周、3、6、12、24个月分别进行CT扫描。在5个不同水平（L1至L5）的矢状面和冠状面测量胫骨隧道。结果：2年内，胫骨隧道矢状面直径平均增长30.6%，冠状面直径平均增长16.4%。隧道中段增大明显（P < 0.05） （L 2/3：矢状面增大44.0%、47.9%，冠状面增大29.8%、29.9%），形成均匀的腔型外观。与其他时间间隔相比，术后前6周隧道大小变化的百分比显著高于其他时间间隔（P < 0.05）。隧道扩大的大小与临床结果之间或隧道扩大与KT-1000测量之间没有相关性。结论：内窥镜前交叉韧带重建与胫骨隧道扩大有关，这在手术后几周内就已经存在。然而，在我们的研究人群中，在24个月的时间内没有发现对临床结果的负面影响。
Purpose: The purpose of this study was to prospectively evaluate changes in the tibial bone tunnel following endoscopic anterior cruciate ligament (ACL) reconstruction with patellar tendon autograft. We used computed tomography (CT) sequentially to monitor the time course of these changes over a 2-year period and correlated the results to clinical outcome and instrumented laxity measurements. Type of Study: Case series. Methods: Thirty-four patients (11 women, 23 men; mean age, 26.4 +/- 4.5 years) who underwent endoscopic patellar tendon ACL reconstruction, were evaluated clinically according to IKDC, Lysholm, and Tegner scores as well as with respect to changes in tibial tunnel morphology over a 2-year period. Subsequent CT scans were performed at 1 and 6 weeks and at 3, 6, 12, and 24 months postoperatively. The tibial bone tunnel was measured in the sagittal and coronal planes at 5 different levels (L1 to L5). Results: The diameters fof the tibial tunnel increased an average overall by 30.6% in the sagittal plane and 16.4% in the coronal plane within 2 years. the enlargement was significantly higher (P < .05) in the mid portion of the tunnel (L 2/3: 44.0% and 47.9% in the sagittal and 29.8% and 29.9% in the coronal plane, respectively), which resulted in a uniform cavity-type appearance. The percentage of change in tunnel size was significantly higher (P < .05) within the first 6 weeks following surgery compared with all other time intervals. No correlation between the amount of tunnel enlargement and the clinical results or between tunnel enlargement and KT-1000 measurements could be detected. Conclusions: Endoscopic ACL reconstruction is associated with tibial tunnel enlargement, which is already present within weeks following surgery. However, no negative effects on the clinical results were found over a 24-month period in our study population.