Tibial tunnel widening following anterior cruciate ligament reconstruction: A retrospective seven-year study evaluating the effects of initial graft tensioning and graft selection.
Tibial tunnel widening following anterior cruciate ligament reconstruction: A retrospective seven-year study evaluating the effects of initial graft tensioning and graft selection.
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DOI：
10.1016/j.knee.2018.08.003
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Fleming BC
中科院分区：
文献类型：
--
作者：
DeFroda SF;Karamchedu NP;Owens BD;Bokshan SL;Sullivan K;Fadale PD;Hulstyn MJ;Shalvoy RM;Badger GJ;Fleming BC
研究7年以上ACL重建患者胫骨隧道加宽的情况，以确定髌骨肌腱（BTB）和腘绳肌腱（HS）移植时初始移植物张力对胫骨加宽和临床结果的影响。90例患者用BTB或HS自体移植物重建，随机采用两种初始移植物张力方案之一；1)张拉以恢复正常的正侧松弛（“低张力”，n=46）， 2)张拉使AP松弛过度约束2mm（“高张力”，n=44）。70例患者有术后资料，其中45例可用于7年复查。随访1年、3年和7年，通过x线片评估隧道加宽情况。比较患者报告的结果。BTB自体移植物的初始直径为10.3±0.5mm（低压）和10.2±0.6mm（高压），最终直径为10.8±0.6mm（低压）和9.9±0.6mm（高压）。HS自体移植物的初始直径为8.1±0.9mm（低压）和8.4±0.7mm（高压），最终直径为11.5±1.1mm（低压）和11.1±0.9mm（高压）。HS自体移植物的受试者，平均隧道直径随时间显著改变（p < 0.001）；BTB自体移植物无明显变化（p= 0.29）。两种张力组在所有时间点HS自体移植物组的直径变化均显著大于BTB组（p< 0.05）。患者报告的结果在张力组或移植物类型之间没有差异。接受ACL-R和HS自体移植的患者在7年内进行胫骨隧道拓宽。无论初始移植物张力如何，自体BTB患者均未出现血管增宽。患者报告的结果相同。
To investigate tibial tunnel widening in ACL reconstruction patients over 7-years to establish the effects of initial graft tension on tibial widening and clinical outcomes when using both patellar tendon (BTB) and hamstring tendon (HS) grafts. Ninety patients were reconstructed with BTB or HS autografts were randomized using one of two initial graft tension protocols; 1) tensioned to restore normal anteroposterior laxity (“low-tension”; n=46) and 2) tensioned to over-constrain AP laxity by 2 mm (“high-tension”; n=44). 70 patients had post-surgical data with 45 available for review at 7 years. Tunnel widening was assessed via radiographs at 1, 3, and 7-year follow-up. Patient reported outcomes were compared. The mean±95% confidence intervals of the initial diameters for the BTB autografts were 10.3±0.5mm (Low-tension) and 10.2±0.6mm (High-tension) with final diameters of 10.8±0.6mm (Low-tension) and 9.9±0.6mm (High-tension). The initial diameters for HS autografts were 8.1±0.9mm (Low-tension) and 8.4±0.7mm (High-tension) with final diameters of 11.5±1.1mm (Low-tension) and 11.1±0.9mm (High-tension). For subjects with HS autografts, mean tunnel diameters significantly changed over time (p <.001); no significant changes were observed in BTB autografts (p=.29). Change in diameter of the HS autograft group remained significantly greater than the BTB group at all time points for both tension groups (p<.05). No differences in patient reported outcomes were found between tension groups or graft types. Patients who undergo ACL-R with HS autograft undergo tibial tunnel widening over 7 years. Patients with BTB autografts did not experience widening, regardless of initial graft tension. Patient reported outcomes were equivalent.
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DOI：
10.1016/j.arthro.2004.04.069
发表时间：
2004-07-01
影响因子：
4.7
作者：
Hantes, ME;Mastrokalos, DS;Paessler, HH
通讯作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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影响因子：
3.8
作者：
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通讯作者：
Tallroth, K
影响因子：
3.8
作者：
Clatworthy, MG;Annear, P;Bartlett, RJ
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Bartlett, RJ
DOI：
10.1007/s00167-016-4204-0
发表时间：
2017-04
期刊：
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
影响因子：
--
作者：
Aga C;Wilson KJ;Johansen S;Dornan G;La Prade RF;Engebretsen L
通讯作者：
Engebretsen L