Leonardi Adriano Barros de Aguiar, Duarte Junior Aires, Severino Nilson Roberto
Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Pavilhão "Fernandinho Simonsen" São Paulo, SP, Brazil.
Acta Ortop Bras. 2014;22(5):240-4. doi: 10.1590/1413-78522014220500338.
To assess the presence of tibial bone tunnel enlargement after surgical reconstruction of the anterior cruciate ligament using quadruple graft of the flexor tendons and correlate the functional results in their presence.
The studied lasted six months and included 25 patients, with ages ranging from 18 to 43 years old. Assessment was based on radiographs taken immediately postoperatively and at the third and sixth month of follow up in the anterior cruciate ligament reconstruction. Reconstruction of ligaments was performed with tendon grafts of the semitendinosus and gracilis muscle fixated in the femur with transverse metal screw and in the tibia with interference screws. Patients were evaluated objectively by tests ligament, graded from zero to four crosses and subjectively by the Lysholm method preoperative and after sixth month follow up.
Significant increase in the tunnels diameters were observed, 20.56% for radiographs in the anteroposterior view, 26.48% in profile view and 23.22% in computed tomography. Descriptive statistics showed significant improvement in subjective and objective clinical parameters.
The bone tunnel enlargement is a phenomenon found in the first months after surgical reconstruction of the anterior cruciate ligament and it has no implications on clinical outcomes in the short term. Level of Evidence II, Prospective Study.
评估使用屈肌腱四重移植进行前交叉韧带手术重建后胫骨骨隧道扩大的情况,并将其存在与功能结果相关联。
研究持续6个月,纳入25例年龄在18至43岁之间的患者。评估基于前交叉韧带重建术后即刻以及随访第3个月和第6个月时拍摄的X线片。使用半腱肌和股薄肌肌腱移植进行韧带重建,股骨端用横向金属螺钉固定,胫骨端用挤压螺钉固定。术前及随访第6个月后,通过韧带测试(从0到4级)对患者进行客观评估,并采用Lysholm方法进行主观评估。
观察到隧道直径显著增加,前后位X线片增加20.56%,侧位片增加26.48%,计算机断层扫描增加23.22%。描述性统计显示主观和客观临床参数有显著改善。
骨隧道扩大是前交叉韧带手术重建后最初几个月出现的一种现象,短期内对临床结果无影响。证据等级II,前瞻性研究。