Evaluation of the vascular status of autogenous hamstring tendon grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography
Evaluation of the vascular status of autogenous hamstring tendon grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography
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DOI：
10.1007/s00167-007-0478-6
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发表时间：
2008-04-01
影响因子：
3.8
通讯作者：
Kubo, Toshikazu
中科院分区：
文献类型：
--
作者：
Arai, Yuji;Hara, Kunio;Kubo, Toshikazu
本研究的目的是利用磁共振血管成像技术评估人类前交叉韧带重建后自体半腱肌移植物的血管状况。研究了12例采用4股半腱肌腱重建前交叉韧带的患者（平均年龄24.3岁）。所有患者在术后平均15.8个月（范围9-22个月）接受了增强磁共振血管造影和二次关节镜检查。血管移植物可见，对比剂增强对股骨隧道、移植物和胫骨隧道的可见性进行评估。磁共振血管造影显示，所有患者膝中动脉分支通过后囊延伸至移植物的上侧，膝下动脉分支终止于移植物的下侧。这些结果与二次关节镜检查的实际结果一致。我们发现所有患者的股骨和胫骨隧道均有造影剂增强。前交叉韧带重建后9个月的增强效果高于22个月。移植物在股侧后部和胫骨侧前部显示增强模式。本研究表明膝中下动脉分支为移植物提供血液供应，这可能影响移植物的成熟。骨隧道的血运重建在韧带-骨隧道连接处的愈合中起重要作用。
The purpose of this study is to evaluate the vascular status of autogenous semitendinosus grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography. Twelve patients (mean age, 24.3 years) who underwent anterior cruciate ligament reconstruction with the 4-strand semitendinosus tendon were studied. All patients underwent contrast-enhanced magnetic resonance angiography and second-look arthroscopy in their reconstructed knees on an average of 15.8 months (range 9-22 months) after surgery. Blood vessels to the graft were visualised and contrast medium enhancement for visualising the femoral tunnel, graft, and tibial tunnel was evaluated. Magnetic resonance angiography showed that a branch of the middle genicular artery extended to the upper side of the graft through the posterior capsule and that branches of the inferior genicular artery ended at the lower side of the graft in all patients. These were consistent with the actual findings of the second-look arthroscopy. We found contrast medium enhancement in the femoral and tibial tunnels in all patients. The effect of enhancement at 9 months after ACL reconstruction was higher than that at 22 months. The graft showed enhancement patterns in the posterior portion of the femoral side and the anterior portion of the tibial side. This study demonstrated that the branches of the middle and inferior genicular arteries provide blood supply to the graft, which may influence the maturation of the graft. The revascularisation of the bone tunnels could play an important role in the healing of the ligament-bone tunnel junction.