2 年随访时，应用磷酸钙-肌腱复合移植物行解剖单束前交叉韧带重建后股骨和胫骨骨道的形态学变化。
Morphological changes in the femoral and tibial bone tunnels after anatomic single-bundle anterior cruciate ligament reconstruction using a calcium phosphate-hybridized tendon graft in 2years of follow-up.
机构信息
Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, 300-0394 Inashiki-gun, Ibaraki, Japan.
Department of Orthopaedic Surgery, Ichihara Hospital, 3681 Oozone, 300-3295 Tsukuba, Ibaraki, Japan.
出版信息
Orthop Traumatol Surg Res. 2019 Jun;105(4):653-660. doi: 10.1016/j.otsr.2019.01.005. Epub 2019 Mar 8.
INTRODUCTION
A calcium phosphate (CaP)-hybridized tendon graft improves tendon-to-bone healing. The purpose of the study was to evaluate the progression of morphological changes in the femoral and tibial bone tunnels after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction using the CaP-hybridized tendon graft versus an untreated tendon graft during 2 years of follow-up.
HYPOTHESIS
We hypothesized that the CaP-hybridized tendon graft would prevent the progression of bone tunnel enlargement compared with the untreated tendon graft.
PATIENTS AND METHODS
The CaP group comprised 19 patients, while the conventional group comprised 18. Computed tomography was performed at postoperative 1 week, 1 year, and 2 years. The bone tunnel enlargement and tunnel translation at the aperture of the femoral and tibial tunnels were analyzed.
RESULTS
In the CaP group, the femoral bone tunnel did not expand during 2 years of follow-up. In the conventional group, the femoral bone tunnel diameters at postoperative 1 year and 2 years were enlarged compared with postoperative 1 week, and the proximal and distal walls of the femoral bone tunnel shifted proximally and distally, respectively. The femoral bone tunnel in the CaP group was smaller than that in the conventional group at 1 year postoperatively. Although the tibial bone tunnels expanded for up to 1 year postoperatively in both groups, the expanded bone tunnel reduced during 2 years of follow-up only in the CaP group.
DISCUSSION
In anatomic single-bundle ACL reconstruction, the femoral bone tunnel in the CaP group did not expand or progress with time compared with the conventional group, while the tibial bone tunnel in the CaP group expanded for up to 1 year postoperatively and then reduced for up to 2 years postoperatively. The CaP-hybridized tendon can prevent the progression of bone tunnel enlargement.
LEVEL OF EVIDENCE
Level II, Low-powered prospective randomized trial.
介绍
磷酸钙（CaP）-杂交肌腱移植物可改善肌腱与骨的愈合。本研究的目的是在 2 年的随访期间，评估使用 CaP 杂交肌腱移植物与未处理的肌腱移植物进行解剖学单束前交叉韧带（ACL）重建后，股骨和胫骨骨隧道的形态变化进展。
假设
我们假设 CaP 杂交肌腱移植物可防止骨隧道扩大的进展，与未处理的肌腱移植物相比。
患者和方法
CaP 组包括 19 例患者，而常规组包括 18 例。术后 1 周、1 年和 2 年进行 CT 检查。分析了股骨和胫骨隧道开口处的骨隧道扩大和隧道平移。
结果
在 CaP 组，股骨骨隧道在 2 年的随访期间没有扩大。在常规组中，股骨骨隧道直径在术后 1 年和 2 年比术后 1 周扩大，股骨骨隧道的近端和远端壁分别向近端和远端移位。术后 1 年，CaP 组的股骨骨隧道比常规组小。尽管两组的胫骨骨隧道在术后 1 年内都有扩大，但只有 CaP 组的扩大骨隧道在 2 年的随访期间减少。
讨论
在解剖学单束 ACL 重建中，与常规组相比，CaP 组的股骨骨隧道在术后 1 年内没有扩大或随时间进展，而 CaP 组的胫骨骨隧道在术后 1 年内扩大，然后在术后 2 年内减少。CaP 杂交肌腱可防止骨隧道扩大的进展。
证据水平
二级，低功率前瞻性随机试验。
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