Ge Yunshen, Li Hong, Tao Hongyue, Hua Yinghui, Chen Jiwu, Chen Shiyi
Department of Sports Medicine, Huashan Hospital, No 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):954-60. doi: 10.1007/s00167-013-2755-x. Epub 2013 Nov 7.
The purpose of the study is to compare tendon-bone healing between autograft tendons and allograft tendons after anterior cruciate ligament (ACL) reconstruction using 3.0T magnetic resonance imaging.
A total of 36 participants (18 with autograft and 18 with allograft reconstruction) underwent MRI scans at least 2 years after the ACL reconstruction operation. Oblique axial images were obtained on three-dimensional dual-echo steady-state images and imported into solid modelling software for three-dimensional model reconstruction of the bone tunnel. The graft signal intensity in the tunnel, tendon-bone interface, tunnel morphology, and tunnel area was analysed using the Siemens software packages to determine the tendon-bone healing between the groups.
For the tunnel morphology, both groups exhibited bone tunnel enlargement either at the femoral or tibial tunnel aperture. For the tendon-bone interface, one patient in the autograft group and two patients in the allograft group exhibited a significant fibrous scar tissue bands at the tendon-bone interface. The graft signal/noise quotient values of the allograft group were higher than the autograft group. However, there was no significant difference in the tunnel area between the allograft group and the autograft group.
Although the autograft tendons exhibited a better remodelling effect than did the allograft tendons in the bone tunnel, there was no significant difference in the tendon-bone healing between the autograft tendons and the allograft tendons postoperatively. These findings indicate that the biomechanical effect of graft motion may play a significant role in the tunnel aperture.
III.
本研究旨在使用3.0T磁共振成像比较前交叉韧带（ACL）重建术后自体肌腱与异体肌腱的腱骨愈合情况。
总共36名参与者（18例行自体移植重建，18例行异体移植重建）在ACL重建手术后至少2年接受了MRI扫描。在三维双回波稳态图像上获取斜轴位图像，并导入实体建模软件以进行骨隧道的三维模型重建。使用西门子软件包分析隧道内的移植物信号强度、腱骨界面、隧道形态和隧道面积，以确定两组之间的腱骨愈合情况。
对于隧道形态，两组在股骨或胫骨隧道开口处均出现骨隧道扩大。对于腱骨界面，自体移植组有1例患者，异体移植组有2例患者在腱骨界面出现明显的纤维瘢痕组织带。异体移植组的移植物信号/噪声商值高于自体移植组。然而，异体移植组和自体移植组之间的隧道面积没有显著差异。
尽管自体肌腱在骨隧道中的重塑效果优于异体肌腱，但自体肌腱和异体肌腱术后的腱骨愈合没有显著差异。这些发现表明，移植物运动的生物力学效应可能在隧道开口中起重要作用。
III级。
