Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India.
Arthroscopy. 2011 Jun;27(6):776-83. doi: 10.1016/j.arthro.2011.02.009.
We prospectively sought to compare the incidence and properties of tunnel widening in patients undergoing anterior cruciate ligament reconstruction with quadrupled hamstring graft by use of either EndoButton CL (Smith & Nephew Endoscopy, Andover, MA) or Transfix (Arthrex, Naples, FL) on the femoral side with a bioabsorbable interference screw in the tibial tunnel by computed tomography scan.
We included 34 patients in the study and randomized them into 2 groups--EndoButton and Transfix groups. An anteromedial portal technique was used to create the femoral tunnels in the EndoButton group, whereas a transtibial technique was used in the Transfix group. A bioabsorbable screw was used on the tibial side in both groups. Thirty patients completed the study protocol, and assessment was done at regular intervals until 12 months of follow-up was reached. The patients underwent computed tomography scans at 2 weeks, 3 months, and 6 months postoperatively. The diameters of the tunnels were measured perpendicular to the long axis of the tunnels on oblique coronal and oblique sagittal planes at 3 levels: aperture, midway, and suspension point. We performed functional scoring with the International Knee Documentation Committee 2000 Subjective Knee Evaluation score and Lysholm score.
Femoral tunnel widening at the aperture and at midway was significantly greater in the EndoButton group compared with the Transfix group. A decrease in the loop length in the EndoButton group was associated with lesser tunnel widening, although this was not found to be statistically significant with the numbers available. A trend toward decreased tunnel widening at the aperture on the tibial side was observed when the tip of the screw was 10 to 15 mm away from the aperture.
Femoral tunnel widening was significantly less in the Transfix group compared with the EndoButton group.
Level II, prospective comparative study.
我们前瞻性地比较了使用 EndoButton CL（Smith & Nephew Endoscopy，马萨诸塞州安多弗）或 Transfix（Arthrex，佛罗里达州那不勒斯）在股骨侧固定四股腘绳肌腱移植物重建前交叉韧带的患者与胫骨隧道中使用生物可吸收干扰螺钉的隧道增宽发生率和性质，通过计算机断层扫描进行评估。
我们将 34 名患者纳入研究，并将其随机分为 2 组 - EndoButton 组和 Transfix 组。EndoButton 组采用前内侧入路技术在股骨侧建立隧道，而 Transfix 组采用经胫骨隧道技术。两组均在胫骨侧使用生物可吸收螺钉。30 名患者完成了研究方案，并在定期评估直至 12 个月随访结束。患者在术后 2 周、3 个月和 6 个月进行计算机断层扫描检查。在斜冠状位和斜矢状位的 3 个平面上（孔径、中点和悬挂点），垂直于隧道长轴测量隧道的直径。我们使用国际膝关节文献委员会 2000 年主观膝关节评估评分和 Lysholm 评分进行功能评分。
与 Transfix 组相比，EndoButton 组在孔径和中点处的股骨隧道增宽明显更大。EndoButton 组的环长减少与隧道增宽减少相关，但由于可用数量有限，这并未显示出统计学意义。当螺钉尖端距离孔径 10 至 15 毫米时，胫骨侧孔径处的隧道增宽趋势减少。
与 EndoButton 组相比，Transfix 组的股骨隧道增宽明显减少。
II 级，前瞻性比较研究。
