Yamagishi T, Fujii K, Roppongi S, Hatsuumi H
Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.
Knee Surg Sports Traumatol Arthrosc. 1998;6(3):160-4. doi: 10.1007/s001670050092.
Laser Doppler flowmetry (LDF) was used to measure blood flow in anterior cruciate ligaments (ACL) reconstructed using a bone-patellar tendon-bone autograft. Thirty-five patients (17 men, 18 women) undergoing second-look arthroscopy for a reconstructed ACL were selected at random for postoperative participation in the study at 6, 12, and 18 months. Eight patients with an intact ACL had their blood flow measured arthroscopically for a control. Under arthroscopic visualization, a 3 mm probe was placed through a trocar sleeve into the ACL. Functional flow was evaluated using LDF, for which the output signal, the blood cell flux (BCF), is expressed in terms of volts. These patients also underwent magnetic resonance imaging (MRI); MRI, IKDC final evaluation, and second-look arthroscopic findings for each patient were compared with the others. In normal ACL, the BCF value ranged from 120 to 130 mV, and synovial blood flow, 90-132 mV. Significantly high BCF values for the reconstructed ACL were noted at 6 and 12 months, but there was no change in synovial BCF postoperatively. There was a gradual return to near normal BCF values for the reconstructed ACL 18 months after surgery. Significantly abnormal BCF values (580 +/- 20 mV) were seen in cases with a severely abnormal IKDC final evaluation; there were few differences in BCF values between normal, nearly normal, and abnormal. LDF is easy to use and appears to be a reproducible technique for evaluating blood flow in the reconstructed ACL, offering distinct advantages for evaluating its maturation. Six months after surgery, there was a decrease in MRI with a high signal intensity, whereas the BCF values in the reconstructed ACL generally needed 18 months to return to near normal; the return was gradual. We believe the blood supply of the reconstructed ACL may originate from the synovium of posterior joint capsule within 6 months after surgery.
激光多普勒血流仪（LDF）用于测量采用自体骨-髌腱-骨移植重建的前交叉韧带（ACL）中的血流情况。随机选取35例（17例男性，18例女性）因ACL重建而接受二次关节镜检查的患者，在术后6个月、12个月和18个月参与本研究。选取8例ACL完整的患者，通过关节镜测量其血流作为对照。在关节镜直视下，将一个3毫米的探头通过套管针置入ACL。使用LDF评估功能性血流，其输出信号即血细胞通量（BCF）以伏特表示。这些患者还接受了磁共振成像（MRI）检查；将每位患者的MRI、国际膝关节文献委员会（IKDC）最终评估结果以及二次关节镜检查结果相互比较。在正常ACL中，BCF值范围为120至130毫伏，滑膜血流为90 - 132毫伏。重建的ACL在术后6个月和12个月时BCF值显著升高，但术后滑膜BCF无变化。术后18个月，重建的ACL的BCF值逐渐恢复至接近正常水平。在IKDC最终评估严重异常的病例中可见显著异常的BCF值（580±20毫伏）；正常、接近正常和异常病例之间的BCF值差异不大。LDF易于使用，似乎是一种可重复的技术，用于评估重建ACL中的血流，在评估其成熟度方面具有明显优势。术后6个月，MRI上高信号强度降低，而重建ACL中的BCF值通常需要18个月才能恢复至接近正常水平；恢复过程是渐进的。我们认为，重建的ACL的血供可能在术后6个月内源自后关节囊的滑膜。
