BONE TUNNEL ENLARGEMENT AFTER ANTERIOR CRUCIATE LIGAMENT REPLACEMENT
BONE TUNNEL ENLARGEMENT AFTER ANTERIOR CRUCIATE LIGAMENT REPLACEMENT
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DOI：
10.1177/036354659402200318
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发表时间：
1994-05-01
影响因子：
4.8
通讯作者：
INDELICATO, PA
中科院分区：
文献类型：
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作者：
FAHEY, M;INDELICATO, PA
射线照相观察到胫骨和股骨隧道尺寸增加。这项回顾性研究比较了 56 个自体移植和 87 个同种异体移植髌腱骨-腱-骨前交叉韧带替代物的胫骨隧道直径，观察到的隧道变化与术后 1 年的临床结果相关。在关节线下方约 1 cm 处测量胫骨隧道硬化边缘。通过使用由同一隧道内已知直径的干涉螺钉确定的放大系数来计算精确的隧道尺寸。与自体移植隧道扩大0.26毫米（-2.5至2.7）相比，同种异体移植隧道平均扩大为1.2毫米（-2.5至6.0）；差异显着（P > 0.0002）。自体移植组和同种异体移植组之间的 KT-1000 关节计测量结果没有显着差异，并且根据改良的 Hughston 膝关节评估系统确定的隧道尺寸增加与临床结果之间没有相关性。隧道测量的再现性通过独立的重复测量得到证实。这种隧道扩大的意义尚不清楚，并且似乎不会对同种异体移植物利用的临床结果产生不利影响。可能的解释包括伴有吸收的免疫反应、干涉螺钉附近导致吸收的应力屏蔽或隧道中滑膜的炎症反应。
Radiographic increase in the size of tibial and femoral tunnels has been observed. This retrospective study compared tibial tunnel diameter in 56 autograft and 87 allograft patellar tendon bone-tendon-bone anterior cruciate ligament replacements whose observed tunnel changes were correlated with clinical results at 1 year postoperatively. Tibial tunnel sclerotic margins were measured approximately 1 cm below the joint line. Exact tunnel dimension was calculated by using a magnification factor determined by the interference screw of known diameter within the same tunnel. Average allograft tunnel enlargement was 1.2 mm (-2.5 to 6.0) compared with the autograft tunnel enlargement of 0.26 mm (-2.5 to 2.7); the difference was significant (P > 0.0002). No significant difference was seen in KT-1000 arthrometer measurements between autograft or allograft groups, and no correlation was seen between increased tunnel size and clinical outcome as determined by the modified Hughston knee evaluation system. Tunnel measurement reproducibility was confirmed by independent repeated measurements. The significance of this tunnel enlargement is unknown and does not appear to adversely affect clinical outcome of allograft utilization. Possible explanations include an immune response with resorption, stress shielding proximal to the interference screw resulting in resorption, or an inflammatory response by synovium in the tunnel.