Gulledge Caleb M, Baumer Timothy G, Juliano Lauren, Sweeney Margaret, McGinnis Michael, Sherwood Alexandria, Moutzouros Vasilios, Bey Michael J
Wayne State University, School of Medicine, 540 E Canfield St, Detroit, MI 48201, United States of America.
Henry Ford Health System, Bone and Joint Center, 6135 Woodward Ave, Detroit, MI 48202, United States of America.
Knee. 2019 Mar;26(2):347-354. doi: 10.1016/j.knee.2018.12.006. Epub 2019 Jan 9.
Anterior cruciate ligament (ACL) ruptures are common and are frequently reconstructed using a patellar tendon (PT) autograft. Unfortunately, the time course of PT healing after ACL reconstruction is not particularly well understood. Thus, the primary objective of this study was to use shear wave elastography (SWE) to evaluate the extent to which shear wave speed (SWS) is associated with time after ACL reconstruction.
Longitudinal SWE images were acquired from lateral, central, and medial regions of the PT from two groups: 30 patients who had undergone ACL reconstruction with a PT autograft within the preceding 40 months, and 30 age-matched asymptomatic control subjects. SWE images were acquired at 20° and 90° of passive flexion from both knees. In each subject group, statistical analyses assessed changes in mean SWS with time post-surgery, as well as differences in mean SWS between PT regions and limbs.
In the ACL reconstruction patients, mean SWS increased with time post-surgery in the lateral region of the involved knee (p = 0.025) and decreased with time post-surgery in the central region of the contralateral knee (p = 0.022).
The findings suggest that there is an association between the mechanical properties of the PT and time post-surgery in both the involved and contralateral limbs after ACL reconstruction. These changes are likely due to maturation of the donor site tissue and changes in gait/loading patterns following ACL rupture and reconstruction.
Level II - Prospective Cohort.
前交叉韧带（ACL）断裂很常见，常采用髌腱（PT）自体移植进行重建。遗憾的是，ACL重建后PT愈合的时间进程尚未得到很好的理解。因此，本研究的主要目的是使用剪切波弹性成像（SWE）来评估剪切波速度（SWS）与ACL重建后时间的关联程度。
从两组患者的PT外侧、中央和内侧区域采集纵向SWE图像：一组为30例在过去40个月内接受PT自体移植进行ACL重建的患者，另一组为30例年龄匹配的无症状对照者。在双膝关节被动屈曲20°和90°时采集SWE图像。在每个受试者组中，统计分析评估术后平均SWS随时间的变化，以及PT区域和肢体之间平均SWS的差异。
在ACL重建患者中，患侧膝关节外侧区域的平均SWS随术后时间增加（p = 0.025），对侧膝关节中央区域的平均SWS随术后时间减少（p = 0.022）。
研究结果表明，ACL重建后，患侧和对侧肢体的PT力学性能与术后时间之间存在关联。这些变化可能是由于供区组织成熟以及ACL断裂和重建后步态/负荷模式的改变。
二级——前瞻性队列研究。
