Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Arthroscopy. 2021 Sep;37(9):2903-2914.e1. doi: 10.1016/j.arthro.2021.03.072. Epub 2021 Apr 20.
To investigate the surgical outcomes of anterior cruciate ligament (ACL) reconstruction using a low-dose irradiated tibialis anterior allograft with a fixed-loop cortical suspension device for the femur based on the graft insertion length (GIL) in the femoral tunnel.
Between January 2010 and January 2018, the medical records of consecutive patients who underwent arthroscopic ACL reconstruction with a tibialis anterior allograft fixed with the EndoButton CL for the femur and who had at least 2 years of follow-up were retrospectively evaluated. Patients were classified into 3 groups based on the GIL in the femoral tunnel (group 1, GIL < 15 mm; group 2, GIL of 15-20 mm; and group 3, GIL > 20 mm), and their functional scores, knee laxity, and radiographic parameters were evaluated.
A total of 91 patients were analyzed. There were no statistically significant differences in the functional scores and knee laxity between the 3 groups at 2 years postoperatively. However, significant differences were observed in tunnel widening at 1 year postoperatively in the femur (P = .045 for absolute value and P = .004 for relative value) and the tibia (P = .014 for absolute value and P = .012 for relative value), revealing that both the femoral and tibial tunnels widened as the GIL decreased. Additional linear regression analyses were performed to identify whether the GIL independently affects tunnel widening. Consequently, the femoral tunnel depth, tunnel diameter, and GIL were found to independently influence femoral tunnel widening (P = .008, P = .019, and P < .001, respectively), whereas the tunnel diameter and GIL affected tibial tunnel widening (P < .001 and P = .004, respectively).
The GIL in the femoral tunnel during ACL reconstruction using a tibialis anterior allograft with a fixed-loop cortical suspension device for the femur has no significant association with the postoperative functional outcomes and knee laxity, but it has a negative correlation with tunnel widening in the femur and the tibia.
Level III, retrospective cohort study.
基于移植物在股骨隧道中的插入长度（GIL），研究使用固定环皮质悬吊装置固定的胫骨前肌同种异体移植物进行前交叉韧带（ACL）重建的手术结果。
回顾性分析 2010 年 1 月至 2018 年 1 月连续接受关节镜 ACL 重建的患者的病历，这些患者均使用 EndoButton CL 固定胫骨前肌同种异体移植物进行股骨固定，并且至少随访 2 年。根据股骨隧道中的 GIL 将患者分为 3 组（组 1，GIL < 15mm；组 2，GIL 为 15-20mm；组 3，GIL > 20mm），评估其功能评分、膝关节松弛度和影像学参数。
共分析了 91 例患者。术后 2 年时，3 组患者的功能评分和膝关节松弛度无统计学差异。然而，术后 1 年时，股骨（绝对值 P=.045，相对值 P=.004）和胫骨（绝对值 P=.014，相对值 P=.012）隧道的隧道增宽存在显著差异，表明随着 GIL 的减少，股骨和胫骨隧道均出现增宽。进一步进行线性回归分析以确定 GIL 是否独立影响隧道增宽。结果表明，股骨隧道深度、隧道直径和 GIL 独立影响股骨隧道增宽（P=.008、P=.019 和 P <.001），而隧道直径和 GIL 影响胫骨隧道增宽（P <.001 和 P=.004）。
使用固定环皮质悬吊装置固定的胫骨前肌同种异体移植物进行 ACL 重建时，股骨隧道中的 GIL 与术后功能结果和膝关节松弛度无关，但与股骨和胫骨隧道的增宽呈负相关。
III 级，回顾性队列研究。
