Shaffer B S, Tibone J E
Department of Orthopaedics, Georgetown University Medical Center, Washington, DC.
Am J Sports Med. 1993 May-Jun;21(3):449-54. doi: 10.1177/036354659302100321.
The purpose of this study was to determine if use of the midthird patellar tendon autograft contributes to or causes patellar tendon shortening or patella baja in anterior cruciate ligament reconstruction. Thirty-six patients undergoing arthroscopically assisted midthird patellar tendon autograft anterior cruciate ligament reconstruction were studied prospectively. Intraoperative patellar tendon length changes were measured. Half of the patients had the tendon defect closed and half had it left open (closing peritenon only). Radiographic tendon length changes and patella baja were assessed using Insall-Salvati and Blackburne-Peel ratios measured on 45 degrees lateral knee radiographs using an adjustable polypropylene jig. Bilateral films were obtained preoperatively and at 2 weeks, 3 months, and 6 months postoperatively. No patients demonstrated evidence of patellar tendon shortening greater than the 5.5% measurement error. Tendon defect closure resulted in negligible tendon shortening intraoperatively, averaging 2.28% (1.11 mm). Of the 18 patients whose defects were closed, 5 showed no shortening. The remaining 13 patients had measurable tendon shortening less than 4% (2 mm). No patients developed patella baja.
本研究的目的是确定在进行前交叉韧带重建时，使用髌腱中1/3自体移植物是否会导致或引起髌腱缩短或低位髌骨。对36例行关节镜辅助下髌腱中1/3自体移植物前交叉韧带重建的患者进行了前瞻性研究。术中测量髌腱长度变化。一半患者的肌腱缺损进行了闭合，另一半则保持开放（仅缝合腱周组织）。使用可调节聚丙烯夹具在膝关节45°侧位X线片上测量Insall-Salvati和Blackburne-Peel比率，以评估影像学上的肌腱长度变化和低位髌骨情况。术前及术后2周、3个月和6个月均拍摄双侧X线片。没有患者的髌腱缩短超过5.5%的测量误差。肌腱缺损闭合导致术中肌腱缩短可忽略不计，平均为2.28%（1.11毫米）。在18例缺损闭合的患者中，5例未出现缩短。其余13例患者的肌腱缩短量可测量，均小于4%（2毫米）。没有患者出现低位髌骨。
