Celik Haluk, Kim Jun-Ho, Lee Sang-Hak, Lee Dae-Hee
Department of Orthopaedic Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Orthop J Sports Med. 2021 Apr 2;9(4):2325967121993811. doi: 10.1177/2325967121993811. eCollection 2021 Apr.
Compared with extracortical suspensory fixation, the close-to-joint transcondylar cross-pin fixation method in anterior cruciate ligament reconstruction (ACLR) is believed to entail less intratunnel graft motion and subsequently lead to less tunnel widening.
To assess femoral tunnel widening via the transcondylar cross-pin method or the suspensory femoral fixation method in patients who had undergone ACLR.
Systematic review; Level of evidence, 4.
This review focused on studies on femoral-tunnel widening after single-bundle ACLR with cross-pin (Rigidfix or Transfix) and/or Endobutton closed loop (CL). Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening after ACLR.
Overall, 19 studies were included in this meta-analysis. There was no significant difference between cross-pin and Endobutton CL fixations in the pooled absolute change in tunnel widening from the immediate postoperative period to the final follow-up; this was true at both the tunnel aperture (2.48 mm [95% CI, 1.76-3.2 mm] vs 2.93 mm [95% CI, 1.73-4.13 mm], respectively; = .527) and the midpoint of the femoral tunnel (2.43 mm [95% CI, 1.77-3.1 mm] vs 2.54 mm [95% CI, -0.33 to 5.42 mm], respectively; = .937). No significant difference was found in the relative percentage of femoral-tunnel widening between the 2 fixation methods (cross-pin, 43.3% [95% CI, 25.8%-60.8%] vs Endobutton CL, 42.0% [95% CI, 34.1%-49.9%]; = .965).
No significant difference in femoral tunnel widening was found to be associated with the use of either cross-pin or extracortical suspensory fixation in patients who underwent single-bundle ACLR.
与皮质外悬吊固定相比，前交叉韧带重建（ACLR）中经髁交叉克氏针固定方法被认为能减少隧道内移植物的移动，进而减少隧道增宽。
评估接受ACLR的患者采用经髁交叉克氏针方法或悬吊股骨固定方法后的股骨隧道增宽情况。
系统评价；证据等级，4级。
本综述聚焦于单束ACLR采用交叉克氏针（Rigidfix或Transfix）和/或Endobutton闭环（CL）后股骨隧道增宽的研究。两名评价者独立记录每项研究的数据，包括样本量和ACLR后隧道增宽的幅度。
总体而言，本荟萃分析纳入了19项研究。从术后即刻至最终随访，交叉克氏针固定与Endobutton CL固定在隧道增宽的合并绝对变化方面无显著差异；在隧道开口处（分别为2.48 mm [95%CI，1.76 - 3.2 mm]与2.93 mm [95%CI，1.73 - 4.13 mm]；P = 0.527）和股骨隧道中点（分别为2.43 mm [95%CI，1.77 - 3.1 mm]与2.54 mm [95%CI， - 0.33至5.42 mm]；P = 0.937）均如此。两种固定方法在股骨隧道增宽的相对百分比方面无显著差异（交叉克氏针，43.3% [95%CI，25.8% - 60.8%]与Endobutton CL，42.0% [95%CI，34.1% - 49.9%]；P = 0.965）。
在接受单束ACLR的患者中，使用交叉克氏针或皮质外悬吊固定在股骨隧道增宽方面未发现显著差异。
