Department of Sports Orthopedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
Depatment of Orthpaedics, JCHO Osaka Hospital, Osaka, Japan.
Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):461-470. doi: 10.1007/s00167-018-5098-9. Epub 2018 Aug 10.
This study aimed to retrospectively compare the enlargement and migration of the femoral tunnel aperture after anatomic rectangular tunnel anterior cruciate ligament (ACL) reconstruction with a bone-patella tendon-bone (BTB) or hamstring tendon (HT) graft using three-dimensional (3-D) computer models.
Thirty-two patients who underwent ACL reconstruction and postoperative computed tomography (CT) at 3 weeks and 6 months were included in this study. Of these, 20 patients underwent ACL reconstruction with a BTB graft (BTBR group), and the remaining 12 with an HT graft (HTR group). The area of the femoral tunnel aperture was extracted and measured using a 3-D computer model generated from CT images. Changes in the area and migration direction of the femoral tunnel aperture during this period were compared between the two groups.
In the HTR group, the area of the femoral tunnel aperture was significantly increased at 6 months compared to 3 weeks postoperatively (P < 0.05). The average area of the femoral tunnel aperture at 6 months postoperatively was larger by 16.0 ± 12.4% in the BTBR group and 41.9 ± 22.2% in the HTR group, relative to that measured at 3 weeks postoperatively (P < 0.05). The femoral tunnel aperture migrated in the anteroinferior direction in the HTR group, and only in the inferior direction in the BTBR group.
The femoral tunnel aperture in the HTR group was significantly more enlarged and more anteriorly located at 6 months after ACL reconstruction, compared to the BTBR group.
IV.
本研究旨在通过三维（3-D）计算机模型，回顾性比较解剖矩形隧道前交叉韧带（ACL）重建后使用骨-髌腱-骨（BTB）或腘绳肌腱（HT）移植物时股骨隧道开口的扩大和迁移。
本研究纳入了 32 例接受 ACL 重建和术后 3 周及 6 个月计算机断层扫描（CT）的患者。其中 20 例采用 BTB 移植物（BTBR 组）进行 ACL 重建，其余 12 例采用 HT 移植物（HTR 组）。使用 CT 图像生成的 3-D 计算机模型提取并测量股骨隧道开口的面积。比较两组在这段时间内股骨隧道开口的面积和迁移方向的变化。
在 HTR 组中，与术后 3 周相比，术后 6 个月时股骨隧道开口的面积显著增加（P < 0.05）。与术后 3 周相比，BTBR 组和 HTR 组术后 6 个月时股骨隧道开口的平均面积分别增加了 16.0±12.4%和 41.9±22.2%（P < 0.05）。HTR 组的股骨隧道开口向前后下方向迁移，而 BTBR 组仅向下方迁移。
与 BTBR 组相比，HTR 组在 ACL 重建后 6 个月时，股骨隧道开口明显扩大，且更向前方。
IV。
