Department of Orthopedic Surgery, Gil Hospital, Gachon University School of Medicine, Incheon, Korea.
Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2243-50. doi: 10.1007/s00167-011-1874-5. Epub 2012 Jan 15.
The purpose of this study was to evaluate the tunnel widening using a multi-planar reformation of MRI (Magnetic Resonance Imaging) in the orientation of the tunnel. The hypotheses of this study were as follows: (1) tunnel widening would be reduced with the above-mentioned technique, (2) the degree of tunnel widening would be different at the site of the tunnels, and (3) the time interval from surgery to MRI acquisition would affect the magnitude of tunnel widening.
Forty double-bundle ACL reconstructed patients who underwent postoperative MRI were enrolled in this study. The postoperative MRI was performed at 26.7 ± 7.4 months in terms of time. The tunnel widening was examined using a multi-planar reformation of MRI in the orientation of the tunnel. Site-specific analysis was performed according to the depth (the entrance, mid, and exit portion) and wall (anterior, posterior, medial, and lateral walls). The correlation between MRI and widening was also evaluated.
The mean tunnel widening of the femoral AM (Anteromedial), femoral PL (Posterolateral), tibial AM, and tibial PL in terms of the most widened diameter was 1.9 (25.4), 2.1 (30.8), 2.5 (32.8), and 3.2 mm (44.5%), respectively. The tibial PL tunnel showed significant widening than the other tunnels. At the entrance, tunnel widening occurred mostly, followed by the order of the mid and exit portion. Correlation analysis of the time interval of MRI acquisition and tunnel widening showed little association.
Tunnel widening after a double-bundle ACL reconstruction using an outside-in technique with press-fitting of the graft was acceptable compared to previously published studies. The tibial PL tunnel showed the most widening among the 4 tunnels examined with the tunnel entrance being most widened area.
Therapeutic case series, Level IV.
本研究旨在评估 MRI（磁共振成像）多平面重建在隧道方向上的隧道增宽情况。本研究的假设如下：（1）隧道增宽会随着上述技术减少；（2）隧道各部位的隧道增宽程度不同；（3）手术至 MRI 采集的时间间隔会影响隧道增宽的程度。
本研究纳入了 40 例接受双束 ACL 重建术后行 MRI 的患者。术后 MRI 检查时间为 26.7±7.4 个月。采用 MRI 多平面重建评估隧道增宽情况。根据深度（入口、中部和出口部分）和壁（前壁、后壁、内侧壁和外侧壁）进行部位特异性分析。还评估了 MRI 与增宽之间的相关性。
股骨 AM（前内侧）、股骨 PL（后外侧）、胫骨 AM 和胫骨 PL 最宽直径的平均隧道增宽分别为 1.9（25.4）、2.1（30.8）、2.5（32.8）和 3.2mm（44.5%）。胫骨 PL 隧道的增宽明显大于其他隧道。入口处隧道增宽最明显，其次是中部和出口处。MRI 采集时间间隔与隧道增宽的相关分析显示相关性不大。
与先前发表的研究相比，采用经皮技术和移植物压配的双束 ACL 重建术后的隧道增宽是可以接受的。在检查的 4 个隧道中，胫骨 PL 隧道增宽最明显，隧道入口处增宽最明显。
治疗性病例系列，IV 级。
