Department of Orthopaedics, NU Hospital Group, Trollhättan/Uddevalla, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Research and Development, NU Hospital Group, Trollhättan, Sweden.
Arthroscopy. 2017 Dec;33(12):2184-2194. doi: 10.1016/j.arthro.2017.06.025. Epub 2017 Aug 16.
To radiographically assess the tibial tunnel up to 5 years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws.
Fifty-one patients underwent anatomic single-bundle ACL reconstruction with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5 years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up.
The mean follow-up period was 65 months (±3.9 months), with a minimum of 59 months. The width of the tibial tunnel on the anteroposterior view was 9.4 mm (±1.4 mm) in the early postoperative period and 9.2 mm (±1.5 mm) at 5 years (P = .64). The corresponding widths on the lateral view were 9.6 mm (±1.5 mm) in the early postoperative period and 9.0 mm (±1.4 mm) at 5 years (P = .014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5 years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment.
In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5 years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws.
Level II, prospective study.
使用自体腘绳肌腱和生物复合材料骨螺钉重建前交叉韧带（ACL）后，对胫骨隧道进行影像学评估，随访时间长达 5 年。
51 例患者接受了解剖学上的单束 ACL 重建，股骨使用金属骨螺钉，胫骨使用生物复合材料骨螺钉。术后早期、术后 2 年和 5 年分别对索引膝关节进行标准的负重前后位和侧位数字射线照相。51 例患者中，40 例（78%）在所有 3 个时间点均进行了影像学评估。术前和 5 年随访时进行了主观和客观的临床评估。
平均随访时间为 65 个月（±3.9 个月），最短随访时间为 59 个月。术后早期胫骨隧道的前后位宽度为 9.4mm（±1.4mm），5 年时为 9.2mm（±1.5mm）（P=0.64）。相应的外侧位宽度分别为 9.6mm（±1.5mm）和 9.0mm（±1.4mm）（P=0.014）。在 40 例患者中的 33 例（83%）中，胫骨隧道的宽度在 5 年时与术后早期相比在 1 个或 2 个视图上均有减小。与术前评估相比，研究组在 5 年随访时，KT-1000 关节松弛度试验（MEDmetric，圣地亚哥，CA）、前抽屉试验、Tegner 活动量表和 Lysholm 膝关节评分均显著改善（P＜0.001）。未发现隧道宽度与 KT-1000 评估之间存在相关性。
在使用生物复合材料骨螺钉重建 ACL 后 5 年，与术后早期相比，在 1 个或 2 个影像学视图上，83%的患者胫骨隧道的宽度减小。
Ⅱ级，前瞻性研究。
