关节内双束移植物的长度在膝关节弯曲时会发生变化：解剖前交叉韧带重建术中的术中测量。

Intraarticular lengths of double-bundle grafts can change during knee flexion: Intraoperative measurements in anatomic anterior cruciate ligament reconstructions.

机构信息

Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, 700-8558 Okayama, Japan; Department of Orthopaedic Surgery, Sumitomo Besshi Hospital, 3-1 Oujicho, Niihama, 792-8543 Ehime, Japan; Department of Orthopaedic Surgery, Kousei Hospital, 3-8-35 Kouseicho, Kitaku, 700-0985 Okayama, Japan.

出版信息

Orthop Traumatol Surg Res. 2021 Apr;107(2):102816. doi: 10.1016/j.otsr.2021.102816. Epub 2021 Jan 20.

DOI:10.1016/j.otsr.2021.102816

PMID:33484904

Abstract

BACKGROUND

The lengths of the anteromedial bundle (AMB) and posterolateral bundle (PLB) change during knee motion in double-bundle anterior cruciate ligament (ACL) reconstruction. However, the actual intraarticular graft length would be affected by the bone tunnel position and tunnel creation angle during ACL reconstruction. The aim of this study was to investigate the intraarticular length change of the AMB and PLB in patients who underwent anatomic double-bundle ACL reconstruction.

HYPOTHESIS

We hypothesized that the PLB would show a more dynamic length change pattern than the AMB during knee flexion at ACL reconstruction.

METHODS

Thirty-two patients (16 men and 16 women) who had isolated ACL injuries with intact menisci were investigated. Anatomic double-bundle ACL reconstructions were performed using semitendinosus tendon autografts at a mean age of 30.6 years. The graft and tunnel lengths were measured intraoperatively. Intraarticular graft lengths and length changes were calculated at 0° and 90° of knee flexion during ACL reconstruction. Intraoperative data were collected prospectively, and analyses were performed retrospectively.

RESULTS

The intraarticular length of the AMB at 0° of knee flexion was 28.1±5.5mm. At 90° of knee flexion, the AMB intraarticular length decreased to 25.6±4.8mm. The intraarticular length of the PLB decreased to 17.7±4.6mm at 90° of knee flexion compared to 22.0±4.2mm at 0° of knee flexion. Changes in the intraarticular graft length during knee flexion were detected more in the PLB (4.1mm) than in the AMB (2.0mm, p=0.01).

DISCUSSION

This study demonstrated that the intraarticular length change of the PLB during knee motion was larger than that of the AMB in anatomic double-bundle ACL reconstructions with semitendinosus tendon autografts and suspensory femoral fixation devices.

LEVEL OF EVIDENCE

IV; retrospective cohort study.

摘要

背景

在前交叉韧带（ACL）重建的双束重建中，前内侧束（AMB）和后外侧束（PLB）的长度会随着膝关节运动而改变。然而，在 ACL 重建过程中，实际的关节内移植物长度会受到骨隧道位置和隧道创建角度的影响。本研究旨在探讨接受解剖双束 ACL 重建的患者的 AMB 和 PLB 关节内长度变化。

假设

我们假设在 ACL 重建时，与 AMB 相比，PLB 在膝关节弯曲时会显示出更动态的长度变化模式。

方法

研究了 32 名（16 名男性和 16 名女性）有完整半月板的孤立 ACL 损伤患者。使用半腱肌腱自体移植物进行解剖双束 ACL 重建，平均年龄为 30.6 岁。术中测量移植物和隧道长度。在 ACL 重建时，计算 0°和 90°膝关节弯曲时的关节内移植物长度和长度变化。前瞻性收集术中数据，并进行回顾性分析。

结果

膝关节 0°时 AMB 的关节内长度为 28.1±5.5mm。膝关节 90°时，AMB 关节内长度减少至 25.6±4.8mm。与膝关节 0°时的 22.0±4.2mm 相比，膝关节 90°时 PLB 的关节内长度减少至 17.7±4.6mm。膝关节弯曲时，关节内移植物长度的变化在 PLB 中检测到 4.1mm，而在 AMB 中检测到 2.0mm（p=0.01）。