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研究前交叉韧带重建术后异位骨化的发生率。

To study the incidence of heterotopic ossification after anterior cruciate ligament reconstruction.

作者信息

Bhandary Bhaskara, Shetty Sudeep, Bangera Vinay V, R Yogaprakash, Kassim Mohammed Shabir, Alva Karan, Bhandary Sudarshan

机构信息

Associate Professor, Department of Orthopaedics.

出版信息

J Clin Diagn Res. 2013 May;7(5):888-91. doi: 10.7860/JCDR/2013/5348.2970. Epub 2013 Mar 28.

Abstract

INTRODUCTION

Previous studies have enumerated the advantages of an arthroscopic Anterior Cruciate Ligament (ACL) reconstruction with the use of a Bone Patellar Tendon Bone (BPTB) graft. Complications are extremely rare in such surgeries and one such known complication, which is an extra-articular heterotophic ossification at the femoral tunnel site, is rarely seen only in few patients.

AIM

To evaluate the incidence of heterotrophic ossifications at the femoral tunnel site and the efficacy of the preventive measures which were undertaken, in patients who had undergone ACL reconstructions with the use of bone patellar tendon bone grafts.

MATERIAL AND METHODS

A total of 285 patients who had ACL tears within a duration of six years, were evaluated prospectively for the incidence of heterotrophic ossifications after they underwent arthroscopic reconstructions with the use of bone patellar tendon bone grafts by the double incision technique. The effect of the efficacy of various preventive measures on the incidence of the heterotophic ossifications post surgery was also studied.

RESULTS

The observed incidence of the heterotophic ossifications was 2.58% in patients whom preventive measures were not used. In contrast, an incidence of 1.54% of similar complications was recorded, after preventive measures were undertaken. Our results showed that heterotophic ossifications after arthroscopic reconstructions with the use of bone patellar tendon bone grafts were a rare complication and that their incidence could be further reduced if preventive measures were taken.

CONCLUSION

The heterotophic ossification is a rare complication after an ACL reconstruction is done with the use of a bone patellar tendon bone graft by the double incision technique. Its incidence reduces significantly after preventive measures are undertaken.

摘要

引言

先前的研究列举了使用髌腱骨(BPTB)移植物进行关节镜下前交叉韧带(ACL)重建的优点。此类手术并发症极为罕见,而一种已知的并发症,即股骨隧道部位的关节外异位骨化,仅在少数患者中很少见。

目的

评估在使用髌腱骨移植物进行ACL重建的患者中,股骨隧道部位异位骨化的发生率以及所采取预防措施的效果。

材料与方法

对285例在六年内发生ACL撕裂的患者进行前瞻性评估,这些患者在通过双切口技术使用髌腱骨移植物进行关节镜重建后,观察异位骨化的发生率。还研究了各种预防措施的效果对术后异位骨化发生率的影响。

结果

未采取预防措施的患者中,异位骨化的观察发生率为2.58%。相比之下,采取预防措施后,类似并发症的发生率为1.54%。我们的结果表明,使用髌腱骨移植物进行关节镜重建后的异位骨化是一种罕见的并发症,如果采取预防措施,其发生率可以进一步降低。

结论

通过双切口技术使用髌腱骨移植物进行ACL重建后,异位骨化是一种罕见的并发症。采取预防措施后,其发生率显著降低。

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Knee Surg Sports Traumatol Arthrosc. 2007 Jan;15(1):39-42. doi: 10.1007/s00167-006-0131-9. Epub 2006 Jun 13.
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HETEROTOPIC OSSIFICATION OF PATELLAR TENDON.
Bull Hosp Joint Dis. 1964 Oct;25:191-200.
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Extensive post-traumatic ossification of the patellar tendon. A report of two cases.
J Bone Joint Surg Br. 1999 Jan;81(1):34-6. doi: 10.1302/0301-620x.81b1.9074.

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