Liu Di, Lu Wenhao, Vithran Djandan Tadum Arthur, Bi Qing, Hong Zheping, Liu Xu, Yuan Dongliang, Chen Can, Xiao Wenfeng, Li Yusheng
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China.
Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Knee Surg Sports Traumatol Arthrosc. 2025 Mar;33(3):803-816. doi: 10.1002/ksa.12398. Epub 2024 Aug 2.
The purpose of this study is to dynamically assess variations in tunnel diameters following anterior cruciate ligament reconstruction (ACLR) and investigate correlations with patient-reported outcomes (PROs) and graft maturity based on signal-to-noise quotient (SNQ).
Tunnel diameter and tunnel position were measured using three-dimensional models derived from computed tomography (CT) data. Postoperative graft maturity and integration were evaluated using magnetic resonance imaging (MRI). Clinical outcomes were assessed through PROs, which included the International Knee Documentation Committee Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Scores and Lysholm scores. The correlation between tunnel enlargement extent, PROs and SNQ values, as well as correlations between confounding factors, tunnel diameter differences and SNQ were analyzed.
A total of 73 participants underwent primary ACLR and scheduled follow-ups. At the segment of the articular aperture, the femoral tunnel was enlarged by 32.3% to 10.4 ± 1.6 mm (p < 0.05), and the tibial tunnel was widened by 17.2% to 9.6 ± 1.2 mm (p < 0.05) at the 6-month follow-up. At 1 year postoperatively, diameters at the articular aperture were not further increased on the femoral (n.s.) and tibial (n.s.) sides. In early postoperative follow-up, the femoral tunnel was anteriorly and distally shifted, coupled with posterior and lateral deviation involving the tibial side, exhibiting minimal migration at 1-year follow-up. The degree of tunnel widening was not correlated with PROs and SNQ values. Age, gender, body mass index (BMI), time from surgery to follow-up, concomitant injuries and autograft type were not correlated with tunnel diameter differences and SNQ.
The femoral and tibial bone tunnels exhibited eccentrical widening and gradually stabilized at 1 year following ACLR. Furthermore, the enlarged bone tunnels were not correlated with unsatisfied PROs and inferior graft maturity.
Level IV.
本研究旨在动态评估前交叉韧带重建术（ACLR）后隧道直径的变化，并基于信噪比（SNQ）研究其与患者报告结局（PROs）及移植物成熟度的相关性。
使用从计算机断层扫描（CT）数据导出的三维模型测量隧道直径和隧道位置。使用磁共振成像（MRI）评估术后移植物的成熟度和整合情况。通过PROs评估临床结局，包括国际膝关节文献委员会主观膝关节评估表、膝关节损伤和骨关节炎结局评分以及Lysholm评分。分析隧道扩大程度、PROs与SNQ值之间的相关性，以及混杂因素、隧道直径差异与SNQ之间的相关性。
共有73名参与者接受了初次ACLR并按计划进行随访。在关节开口段，随访6个月时，股骨隧道扩大了32.3%，至10.4±1.6mm（p<0.05），胫骨隧道增宽了17.2%，至9.6±1.2mm（p<0.05）。术后1年，股骨侧（无统计学意义）和胫骨侧（无统计学意义）关节开口处的直径未进一步增加。在术后早期随访中，股骨隧道向前和向远端移位，同时胫骨侧出现向后和向外侧偏移，在1年随访时移位最小。隧道增宽程度与PROs和SNQ值无关。年龄、性别、体重指数（BMI）、手术至随访的时间、合并损伤和自体移植物类型与隧道直径差异和SNQ无关。
ACLR术后1年，股骨和胫骨骨隧道出现偏心性增宽并逐渐稳定。此外，扩大的骨隧道与不满意的PROs和较差的移植物成熟度无关。
IV级。
