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在使用髌腱与腘绳肌移植物的单束前交叉韧带重建中,隧道扩大和隧道定位与短期功能结果的相关性:一项前瞻性研究。

Correlation of tunnel widening and tunnel positioning with short-term functional outcomes in single-bundle anterior cruciate ligament reconstruction using patellar tendon versus hamstring graft: a prospective study.

作者信息

Biswal Udit Kumar, Balaji Gopisankar, Nema Sandeep, Poduval Murali, Menon Jagdish, Patro Dilip Kumar

机构信息

Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.

出版信息

Eur J Orthop Surg Traumatol. 2016 Aug;26(6):647-55. doi: 10.1007/s00590-016-1809-4. Epub 2016 Jul 4.

DOI:10.1007/s00590-016-1809-4
PMID:27376940
Abstract

OBJECTIVE

To study the correlation between tunnel widening and tunnel position with short-term functional outcomes post-ACL reconstruction with patellar tendon and hamstring autografts in young adults.

MATERIALS AND METHODS

A total of 33 patients who underwent ACL reconstruction between October 2013 and February 2015 were included and followed up for 6 months. A standardized surgical technique was used for each graft type. Intra-op arthroscopy findings and drilled tunnel diameters were noted. They were followed up for 3 and 6 months. Radiological assessment was done at 3 and 6 months with clinical score assessment at 6 months.

RESULTS

At 6 months, clinical scores were comparable in both groups. Tunnel widening in both femoral and tibial tunnel at 3 and 6 months were significantly higher in STG group (p values <0.05). The rate of widening was higher in 0-3 months and reduced in 3-6 months. There was statistically significant negative correlation between femoral tunnel widening by CT and IKDC score at 6 months (p value 0.049). We found a positive correlation between posterior positioning of femoral tunnel and Lysholm and IKDC scores. The correlation with Lysholm scores was statistically significant (p value 0.046).

CONCLUSION

To conclude, tunnel widening is more with hamstrings graft. Femoral tunnel widening has significant negative correlation with that of IKDC scores at 6 months. Posterior femoral tunnel positioning and Lysholm scores at 6 months had significant correlation.

摘要

目的

研究青年成人采用髌腱和腘绳肌自体移植物进行前交叉韧带(ACL)重建术后,隧道增宽与隧道位置和短期功能结果之间的相关性。

材料与方法

纳入2013年10月至2015年2月期间接受ACL重建的33例患者,并随访6个月。每种移植物类型均采用标准化手术技术。记录术中关节镜检查结果和钻出的隧道直径。对患者进行3个月和6个月的随访。在3个月和6个月时进行影像学评估,并在6个月时进行临床评分评估。

结果

6个月时,两组临床评分相当。3个月和6个月时,半腱肌-股薄肌(STG)组股骨和胫骨隧道的增宽均显著更高(p值<0.05)。0至3个月增宽率较高,3至6个月降低。6个月时,CT测量的股骨隧道增宽与国际膝关节文献委员会(IKDC)评分之间存在统计学显著的负相关(p值0.049)。我们发现股骨隧道后位与Lysholm评分和IKDC评分之间呈正相关。与Lysholm评分的相关性具有统计学意义(p值0.046)。

结论

总之,腘绳肌移植物的隧道增宽更明显。6个月时,股骨隧道增宽与IKDC评分呈显著负相关。股骨隧道后位与6个月时的Lysholm评分具有显著相关性。

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