Fujii Masataka, Furumatsu Takayuki, Miyazawa Shinichi, Tanaka Takaaki, Inoue Hiroto, Kodama Yuya, Masuda Kenji, Seno Noritaka, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Sumitomo Besshi Hospital, 3-1 Ojicho, Niihama, 792-8543, Japan.
Int Orthop. 2016 Dec;40(12):2553-2558. doi: 10.1007/s00264-016-3298-9. Epub 2016 Sep 30.
Precise pre-tensioning protocol of the graft has not been determined in anterior cruciate ligament (ACL) reconstruction. The aims of this study are to measure the human autologous graft elongation, and to reveal what portion of the graft elongated greater after pre-tensioning in ACL reconstruction.
Twenty-four hamstring tendon grafts which were harvested from patients were included. A continuous load of 150 N was applied to the graft twice for 30 seconds each (150 N-1 minute), and the same loading was repeatedly applied (150 N-2 minute). The amount of elongation of the tendon portion (Length T) and the stitched portion (Length S) were measured after each pre-tensioning.
Length S gradually increased by 1.57 ± 0.67 mm after the 150 N-1 minute pre-tensioning and by 2.12 ± 0.76 mm after the 150 N-2 minute pre-tensioning, respectively. Length T was not significantly elongated after 150 N-1 min (p = 0.66) and 150 N-2 min (p = 0.59).
Graft elongation of the approximately 2 mm was observed, particularly in the stitched portion. It is necessary for a surgeon to focus on careful removal of slack from each stitch during suturing.
在前交叉韧带(ACL)重建中,尚未确定移植物精确的预张紧方案。本研究的目的是测量人体自体移植物的伸长情况,并揭示在ACL重建中预张紧后移植物的哪一部分伸长更大。
纳入从患者身上获取的24条腘绳肌腱移植物。对移植物施加150 N的持续负荷,每次持续30秒,共施加两次(150 N - 1分钟),并重复相同负荷(150 N - 2分钟)。每次预张紧后测量肌腱部分(长度T)和缝合部分(长度S)的伸长量。
在150 N - 1分钟预张紧后,长度S分别逐渐增加1.57±0.67 mm,在150 N - 2分钟预张紧后增加2.12±0.76 mm。在150 N - 1分钟(p = 0.66)和150 N - 2分钟(p = 0.59)后,长度T没有显著伸长。
观察到移植物伸长约2 mm,特别是在缝合部分。外科医生在缝合过程中必须注意仔细消除每一针的松弛。