Chang Chong Bum, Seong Sang Cheol, Kim Tae Kyun
Joint Reconstruction Center, Seoul National University, Bundang Hospital, Seongnamsi, Gyunggido, Korea.
Am J Sports Med. 2009 Feb;37(2):376-82. doi: 10.1177/0363546508324971. Epub 2008 Nov 25.
A bone patellar tendon bone autograft is one of the standard graft choices for anterior cruciate ligament reconstruction. However, its use can be limited when the patellar tendon is too narrow or too long.
A preoperative assessment of patellar tendon dimensions using magnetic resonance imaging would be accurate and reliable. Patients undergoing anterior cruciate ligament reconstruction would have wide ranges of patellar tendon dimensions, and a significant proportion of patients would have a too narrow and/or too long patellar tendon as the graft choice. There would be a demographic predictor to identify the patients with inappropriate patellar tendon dimensions.
Cohort study (diagnosis); Level of evidence, 3.
The accuracy and reliability of magnetic resonance assessments of patellar tendon dimensions were assessed by comparing the intraoperative measurements using a ruler in 55 knees and 10 knees, respectively. Data from the magnetic resonance assessments in 147 knees undergoing anterior cruciate ligament reconstruction were used for the normative documentation of the patellar tendon dimensions (width, thickness, and length) and identification of demographic predictors for the dimensions.
Preoperative magnetic resonance assessments of the patellar tendon dimensions were accurate and reliable. Korean patients undergoing anterior cruciate ligament reconstruction had wide variations in patellar dimensions, and a significant portion of the patients had an inappropriate patellar tendon (longer than 5 cm in 4.1% and narrower than 27 mm at middle portion in 15.6%) for the graft source. Patient height was the predictor used for patellar tendon width. The mathematical equation used to estimate the width based on patient height was: tendon width at middle portion (mm) = 0.202 x patient height (cm) - 5.07.
Preoperative magnetic resonance assessment of patellar tendon dimensions can be a valuable tool with satisfactory accuracy and reliability when the autologous patellar tendon is considered as the graft source for anterior cruciate ligament reconstruction.
骨-髌腱-骨自体移植物是前交叉韧带重建的标准移植物选择之一。然而，当髌腱过窄或过长时，其应用可能会受到限制。
使用磁共振成像对髌腱尺寸进行术前评估将是准确且可靠的。接受前交叉韧带重建的患者髌腱尺寸范围广泛，并且相当一部分患者会有髌腱过窄和/或过长而不适合作为移植物选择。会有一个人口统计学预测指标来识别髌腱尺寸不合适的患者。
队列研究（诊断）；证据等级，3级。
分别通过比较55例膝关节和10例膝关节术中使用尺子的测量结果，评估磁共振对髌腱尺寸评估的准确性和可靠性。来自147例接受前交叉韧带重建膝关节的磁共振评估数据用于髌腱尺寸（宽度、厚度和长度）的规范记录以及尺寸的人口统计学预测指标识别。
术前磁共振对髌腱尺寸的评估准确且可靠。接受前交叉韧带重建的韩国患者髌腱尺寸差异很大，并且相当一部分患者的髌腱作为移植物来源不合适（4.1%的患者髌腱长度超过5 cm，15.6%的患者髌腱中部宽度小于27 mm）。患者身高是髌腱宽度的预测指标。根据患者身高估计宽度的数学公式为：髌腱中部宽度（mm）= 0.202×患者身高（cm）- 5.07。
当自体髌腱被视为前交叉韧带重建的移植物来源时，术前磁共振对髌腱尺寸的评估可以是一个具有令人满意准确性和可靠性的有价值工具。
