Kim Byung Kag, Kim Tae Won, Hwang Chul Ho, Park Hong Ki, Hwang Kyung Hoon, Sim Jae Ang, Lee Yong Seuk, Lee Beom Koo
Department of Orthopedic Surgery, Joint Center, Sungmin Hospital, Incheon.
Department of Orthopedic Surgery, Gil Medical Center, Incheon.
Knee Surg Relat Res. 2019 Mar 1;31(1):37-43. doi: 10.5792/ksrr.18.012.
This study was to evaluate changes of the mechanical loading pattern after anatomic anterior cruciate ligament (ACL) reconstruction by analyzing uptake patterns using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT).
On SPECT/CT, high signal intensity of the articular surface which shows biological activity and mean increase of mechanical loading was compared with that of the tibiofemoral shaft as a comparative signal. The proportion of positive signals was evaluated in all compartments of the operated knee. Analysis was performed according to combined injury.
A relatively high proportion of positive signals was detected in the posterior zone of the lateral tibial plateau (23.5%) and trochlear groove (23.5%) although increased signal intensity was detected in all compartments. There was no statistical difference depending on the presence of combined injury and between single-bundle and double-bundle ACL reconstruction.
Following anatomic ACL reconstruction, higher signal intensity was detected, particularly in the posterior part of the lateral tibial plateau and trochlear groove. Close observation for further signal changes or osteoarthritic changes would be required even if there was no combined injury and anatomic reconstruction was performed.
本研究旨在通过使用单光子发射计算机断层扫描与传统计算机断层扫描相结合的方法（SPECT/CT）分析摄取模式，评估解剖学前交叉韧带（ACL）重建后机械负荷模式的变化。
在SPECT/CT上，将显示生物活性且机械负荷平均增加的关节表面高信号强度与胫股骨干的信号强度进行比较，作为对照信号。评估手术膝关节所有腔室中阳性信号的比例。根据合并损伤情况进行分析。
尽管在所有腔室中均检测到信号强度增加，但在外侧胫骨平台后部（23.5%）和滑车沟（23.5%）检测到相对较高比例的阳性信号。根据是否存在合并损伤以及单束和双束ACL重建之间，均无统计学差异。
解剖学ACL重建后，检测到较高的信号强度，特别是在外侧胫骨平台后部和滑车沟。即使没有合并损伤且进行了解剖学重建，也需要密切观察进一步的信号变化或骨关节炎变化。
