Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Arthroscopy. 2012 Dec;28(12):1826-32. doi: 10.1016/j.arthro.2012.06.010. Epub 2012 Oct 17.
The primary aim was to determine the rate and risk factors of double biodegradable femoral cross-pin breakage after anterior cruciate ligament reconstruction using a hamstring autograft. In addition, we compared clinical outcomes and magnetic resonance imaging (MRI) findings related to grafts for knees with and without a broken cross-pin.
A retrospective review of 53 knees (53 patients) was performed. Cross-pin breakage was determined by follow-up MRI. Age, sex, weight, height, presence of a posterior transcortical cross-pin breach, time between surgery and follow-up MRI, graft diameter, and cross-pin position (superior or inferior) were included in the analysis. Differences in Lysholm knee scores, International Knee Documentation Committee grades, anterior laxity, and pivot-shift test results were examined in relation to cross-pin breakage. In addition, anterior cruciate ligament graft integrity and osseous graft integration by MRI were assessed and compared between knees with broken cross-pins and knees with intact cross-pins.
A cross-pin was broken in 25 of 53 knees. A cross-pin posterior transcortical breach was the only factor found to be significantly correlated with cross-pin breakage (odds ratio, 6.117; P = .033) by univariate analysis. No significant differences in clinical outcomes were found to be related to cross-pin breakage, but femoral tunnel enlargement was more frequent in knees with breakage than in those without (P = .002).
Breakage of biodegradable cross-pins used for femoral fixation is relatively common but did not affect clinical outcomes. However, femoral tunnel enlargement was found to be greater in knees with a broken cross-pin. The only significant relation found was between a cross-pin posterior transcortical breach and breakage, which suggests that pin breakage is related to a technical error. These findings should be borne in mind when a double biodegradable cross-pin is being considered for femoral fixation.
Level IV, therapeutic case series.
本研究旨在确定使用自体腘绳肌腱重建前交叉韧带（ACL）后双可吸收股骨交叉钉断裂的发生率和风险因素。此外，我们比较了伴有和不伴有交叉钉断裂的膝关节的临床结果和与移植物相关的磁共振成像（MRI）发现。
回顾性分析了 53 例膝关节（53 例患者）。通过随访 MRI 确定交叉钉断裂。分析中包括年龄、性别、体重、身高、是否存在后皮质交叉钉穿透、手术与随访 MRI 之间的时间、移植物直径以及交叉钉的位置（上或下）。检查了交叉钉断裂与 Lysholm 膝关节评分、国际膝关节文献委员会（IKDC）分级、前向松弛度和前抽屉试验结果之间的差异。此外，还评估并比较了 MRI 显示的 ACL 移植物完整性和骨-移植物整合情况，比较了伴有和不伴有交叉钉断裂的膝关节。
53 例膝关节中有 25 例交叉钉断裂。单因素分析发现，只有后皮质交叉钉穿透是与交叉钉断裂显著相关的因素（优势比，6.117；P =.033）。与交叉钉断裂相关的临床结果无显著差异，但与无交叉钉断裂的膝关节相比，有交叉钉断裂的膝关节股骨隧道扩大更为常见（P =.002）。
用于股骨固定的可吸收交叉钉断裂较为常见，但不影响临床结果。然而，在有交叉钉断裂的膝关节中，发现股骨隧道扩大更为明显。唯一发现的显著相关性是交叉钉后皮质穿透与断裂之间的相关性，这表明钉断裂与技术错误有关。在考虑使用双可吸收交叉钉进行股骨固定时，应牢记这些发现。
IV 级，治疗性病例系列。
