Hospital for Special Surgery, New York, NY, USA.
J Am Acad Orthop Surg. 2010 Nov;18(11):695-706. doi: 10.5435/00124635-201011000-00007.
Widening of the tibial and femoral tunnels can present a substantial obstacle during revision anterior cruciate ligament reconstruction because of the associated bone loss and poor graft fixation. Delayed incorporation of soft-tissue grafts into bone and decreased graft stability are of particular concern. The degree to which mechanical (eg, graft position, fixation method) and biologic (eg, increased cytokine levels, synovial fluid propagation) factors contribute to tunnel widening remains unclear. Radiography, CT, and MRI can be used to characterize the extent of widening and aid in preoperative planning. Although many management methods exist, revision surgery remains difficult. Controversy persists regarding the clinical significance, contributing factors, prophylactic measures, and effective management of tunnel widening following anterior cruciate ligament reconstruction.
在进行前交叉韧带重建的翻修手术时，由于存在相关的骨量丢失和移植物固定不良的问题，因此胫骨和股骨隧道的增宽会成为一个很大的障碍。人们尤其关注软组织移植物与骨骼的延迟融合以及移植物稳定性的降低。机械因素（例如移植物位置、固定方法）和生物因素（例如细胞因子水平升高、滑液传播）在多大程度上导致隧道增宽尚不清楚。放射线检查、CT 和 MRI 可用于描述增宽的程度，并有助于术前规划。尽管存在许多治疗方法，但翻修手术仍然具有挑战性。在前交叉韧带重建后，关于隧道增宽的临床意义、相关因素、预防措施和有效管理仍存在争议。
