Nurmi Janne T, Kannus Pekka, Sievänen Harri, Järvelä Timo, Järvinen Markku, Järvinen Teppo L N
Medical School and the Institute of Medical Technology, University of Tampere, Tampere, Finland.
Am J Sports Med. 2004 Mar;32(2):411-7. doi: 10.1177/0363546503261701.
Compaction of the bone-tunnel walls by serial dilation is believed to enhance the interference screw fixation strength of the soft tissue grafts in anterior cruciate ligament (ACL) reconstruction.
Serial dilation enhances the fixation strength of soft tissue grafts in ACL reconstruction over extraction drilling.
Randomized experimental study.
Initial fixation strength of the doubled anterior tibialis tendon grafts (fixed with a bioabsorbable interference screw) was assessed in 21 pairs of human cadaver tibiae with either serially dilated or extraction-drilled bone tunnels. The specimens were subjected to a cyclic-loading test, and those surviving were then tested using the single-cycle load-to-failure test.
During the cyclic-loading test, there were 3 fixation failures in the serially dilated and 6 failures in the extraction-drilled specimens but no significant stiffness or displacement differences between the groups. In the subsequent load-to-failure test, the average yield loads were 473 +/- 110 N and 480 +/- 115 N for the 2 groups respectively (P =.97) and no difference with regard to stiffness or mode of failure.
Serial dilation does not increase the strength of interference fixation of soft tissue grafts in ACL reconstruction over extraction drilling.
The results of this experiment do not support the use of serial dilators in ACL reconstruction.
在膝关节前交叉韧带（ACL）重建中，通过连续扩张来压实骨隧道壁被认为可增强软组织移植物的干涉螺钉固定强度。
与单纯钻孔抽取相比，连续扩张能增强ACL重建中软组织移植物的固定强度。
随机实验研究。
在21对人尸体胫骨上，使用连续扩张或单纯钻孔抽取的骨隧道，评估双股胫骨前肌腱移植物（用可吸收干涉螺钉固定）的初始固定强度。对标本进行循环加载测试，存活的标本随后进行单周期破坏载荷测试。
在循环加载测试中，连续扩张组有3例固定失败，单纯钻孔抽取组有6例失败，但两组之间在刚度或位移上无显著差异。在随后的破坏载荷测试中，两组的平均屈服载荷分别为473±110 N和480±115 N（P = 0.97），在刚度或破坏模式方面无差异。
在ACL重建中，与单纯钻孔抽取相比，连续扩张不会增加软组织移植物干涉固定的强度。
本实验结果不支持在ACL重建中使用连续扩张器。
