MedSport, Department of Orthopaedic Surgery, University of Michigan, Lobby C, 24 Frank Lloyd Wright Dr., Ann Arbor, MI 48106, USA.
Knee Surg Sports Traumatol Arthrosc. 2013 Mar;21(3):606-14. doi: 10.1007/s00167-012-1989-3. Epub 2012 Apr 5.
To assess the potential for regeneration of the hamstring tendons after harvesting for various soft tissue reconstructive procedures, this study uses dynamic, high-resolution ultrasound to evaluate the presence of any tissue in the harvest gap and to characterize tissue functionality.
Patients who underwent ACL reconstruction using ipsilateral hamstring autograft were identified in the database of a single surgeon. Dynamic 12-MHz sonographic imaging was used to evaluate the ipsilateral and contralateral (control) semitendinosus tendons from their insertion sites to proximal muscle bellies. The presence or absence and echogenicity of tissue in the harvest defect, tissue appearance, degree of retraction of the proximal tendon stump, thickness of gap tissue, and motion of the proximal tendon stump were recorded. Data were analysed with Wilcoxon-Mann-Whitney, sign or binomial tests, with significance of P < 0.05.
Eighteen knees in 15 patients (aged 17-51 years) were studied. The proximal amputated stump was retracted an average of 9.0 ± 7.6 cm (range, 0-18 cm; P = 0.0063). With dynamic testing, 9 of 15 knees demonstrated decreased excursion of the proximal tendon stump when compared to the native, contralateral muscle-tendon unit (P = 0.0039). Tissue was detected in the harvest gap in nine knees, five of which had harvest gap tissue with a disorganized appearance compared to the native tendon (P < 0.0001). Six of these nine knees had tissue in the gap demonstrating either less or no excursion with active knee flexion when compared to the native, contralateral side (P = 0.0313).
The presence of tissue in the harvest gap after ACL reconstruction is variable. When tissue is present, there is proximal retraction of the musculotendinous junction and disorganized appearance of the tissue that does not demonstrate normal excursion or physiological function similar to the native muscle-tendon unit.
Case series, Level IV.
为了评估在各种软组织重建手术中采集腘绳肌腱后肌腱再生的潜力，本研究使用动态、高分辨率超声来评估采集间隙中是否存在任何组织，并对组织功能进行特征描述。
在一位外科医生的数据库中，确定了接受同侧腘绳肌腱自体移植物进行前交叉韧带重建的患者。使用 12MHz 动态超声成像，从插入点到近端肌腹评估同侧和对侧（对照）半腱肌腱。记录采集缺陷处组织的存在与否和回声特性、组织外观、近端肌腱残端的回缩程度、间隙组织的厚度以及近端肌腱残端的运动。使用 Wilcoxon-Mann-Whitney、符号或二项式检验对数据进行分析，P 值<0.05 为差异有统计学意义。
研究了 15 名患者（年龄 17-51 岁）的 18 个膝关节。近端截断残端平均回缩 9.0±7.6cm（范围，0-18cm；P=0.0063）。与正常的、对侧肌肉-肌腱单位相比，15 个膝关节中有 9 个在动态测试时近端肌腱残端的活动度减小（P=0.0039）。在 9 个膝关节中检测到采集间隙中有组织，其中 5 个与正常肌腱相比，采集间隙组织外观紊乱（P<0.0001）。与正常的、对侧相比，这 9 个膝关节中有 6 个在主动膝关节屈曲时，间隙中的组织活动度减小或无活动度（P=0.0313）。
在前交叉韧带重建后，采集间隙中组织的存在是多变的。当存在组织时，会出现近端肌腱-肌腹连接处回缩，以及组织紊乱，无法表现出类似于正常肌肉-肌腱单位的正常活动度或生理功能。
病例系列，IV 级。
