Klein Scott A, Nyland John, Caborn David N M, Kocabey Yavuz, Nawab Akbar
Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, 210 East Gray St., Suite 1003, Louisville, KY 40202, USA.
Surg Radiol Anat. 2005 Dec;27(5):372-6. doi: 10.1007/s00276-005-0007-6. Epub 2005 Oct 20.
Adequate tibial bone mineral density (BMD) is essential to soft tissue graft fixation during anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare volumetric bone plug density measurements at the tibial region of interest for ACL reconstruction using a standardized immersion technique and Archimedes' principle. Cancellous bone cores were harvested from the proximal, middle, and distal metaphyseal regions of the lateral tibia and from the standard tibial tunnel location used for ACL reconstruction of 18 cadaveric specimens. Proximal tibial cores displayed 32.6% greater BMD than middle tibial cores and 31.8% greater BMD than distal tibial cores, but did not differ from the BMD of the tibial tunnel cores. Correlational analysis confirmed that the cancellous BMD in the tibial tunnel related to the cancellous BMD of the proximal and distal lateral tibial metaphysis. In conjunction with its adjacent cortical bone, the cancellous BMD of the region used for standard tibial tunnel placement provides an effective foundation for ACL graft fixation. In tibia with poor BMD, bicortical fixation that incorporates cortical bone from the distal tibial tunnel region is recommended.
足够的胫骨骨密度（BMD）对于前交叉韧带（ACL）重建过程中软组织移植物的固定至关重要。本研究的目的是使用标准化浸入技术和阿基米德原理，比较ACL重建感兴趣的胫骨区域的骨块体积密度测量值。从18个尸体标本的胫骨外侧近端、中端和远端干骺端区域以及用于ACL重建的标准胫骨隧道位置采集松质骨芯。胫骨近端骨芯的骨密度比胫骨中端骨芯高32.6%，比胫骨远端骨芯高31.8%，但与胫骨隧道骨芯的骨密度无差异。相关性分析证实，胫骨隧道内的松质骨密度与胫骨外侧近端和远端干骺端的松质骨密度相关。与相邻皮质骨相结合，用于标准胫骨隧道放置区域的松质骨密度为ACL移植物固定提供了有效的基础。对于骨密度较差的胫骨，建议采用双皮质固定，将胫骨远端隧道区域的皮质骨纳入其中。
