Wang Cheng, Ao Ying-Fang
Institute of Sports Medicine, Third Hospital of Peking University, Beijing 100083, China.
Zhonghua Wai Ke Za Zhi. 2008 Jan 15;46(2):90-3.
To measure the size and change of bone tunnel in arthroscopic assisted anterior cruciate ligament (ACL) reconstruction with hamstring tendon autograft by X-ray, and evaluate the incidence, extent, shape and reasons of the bone tunnel expansion and analyze the relationship between bone tunnel expansion and clinical results.
Fifty-one cases of arthroscopic ACL reconstruction with hamstring tendon autograft were performed, and they were followed up at average of 16 months postoperatively. The diameter, shape, position and angle of femoral and tibial bone tunnel were measured using X-ray, and other clinical information had been collected including gender, age, method of tibial fixation, range of motion, KT 2000 and evaluation of muscle strength and so on. All data were entered into the computerized relational database to analyze and compare using the chi square test and correlation analysis.
The incidence of tunnel expansion after ACL reconstruction was 85%-94% in femoral tunnel and 65% in tibial tunnel. The extent of tunnel expansion was 51%-53% in femoral tunnel and 40%-44% in tibial tunnel. The most common shape of tibial tunnel was type O in the A-P X-ray view and type V in the lateral X-ray view. Femoral tunnels anterior to the expected ones were more likely to enlarge. Tibial tunnels anterior to the expected ones were easier to expand. An acute tibial or femoral tunnel angle could result in the femoral tunnel expansion.
The incidence and extent of bone tunnel expansion in arthroscopic ACL reconstruction with hamstring tendon autograft are more significant in femoral tunnel than in tibial tunnel. Bone tunnel expansion is correlated to patients' age, height, BMI and location of the tunnel. The main factors related to bone tunnel expansion are the location and angle of the tunnel.
通过X线测量关节镜辅助下自体腘绳肌腱重建前交叉韧带（ACL）时骨隧道的大小及变化，评估骨隧道扩大的发生率、程度、形态及原因，并分析骨隧道扩大与临床结果之间的关系。
对51例行关节镜下自体腘绳肌腱重建ACL的患者进行研究，术后平均随访16个月。采用X线测量股骨和胫骨骨隧道的直径、形态、位置及角度，并收集其他临床资料，包括性别、年龄、胫骨固定方法、活动范围、KT 2000以及肌力评估等。所有数据录入计算机关系数据库，采用卡方检验和相关分析进行分析比较。
ACL重建后股骨隧道扩大的发生率为85%-94%，胫骨隧道为65%。股骨隧道扩大程度为51%-53%，胫骨隧道为40%-44%。胫骨隧道在前后位X线片上最常见的形态为O型，在侧位X线片上为V型。位于预期位置前方的股骨隧道更易扩大。位于预期位置前方的胫骨隧道更容易扩大。胫骨或股骨隧道角度过锐可导致股骨隧道扩大。
关节镜下自体腘绳肌腱重建ACL时，股骨隧道骨隧道扩大的发生率和程度比胫骨隧道更显著。骨隧道扩大与患者年龄、身高、体重指数及隧道位置相关。与骨隧道扩大相关的主要因素是隧道的位置和角度。
