自体骨—髌腱—骨前交叉韧带重建术后胫骨隧道的变化

摘要

Objective To evaluate the changes ot tibial tunnel diameter alter anterior cruciate ligament( aul; reconstruction with aurologous bone - patellar tendon - bone (BPTB) by X-ray computer tomography (CT). Methods Review the 52 parients(S2 keens) suffered ACL reconstruction with autologous BPTB, 64-slice-CT examinations and three dimensional reconstruction were taken in each patient at the 1,10 weeks and 12 months after surgery. Tibial tunnel diameter of 1 cm blow the articular suface,l cm above the outside mouth of tibial tunnel and the midpoint of tibial tunnel were measured, the percentage of the tibial tunnel enlargement were calculated. Results The tibial tunnel enlargement of 52 parients in average was 11.18% ± 3.39% after 1 week, 25.98% ±4.36% after 10 weeks, 26.24% ±4.44% after 12 months. Compared the percentage of the tibial tunnel enlargement between the 1 week and the 10 weeks after surgery, P <0.05, between the 10 weeks and the 12 months postoperatively, P >0.05. Conclusion Tibial tunnel diameter enlarged after ACL reconstruction with BPTB from autograft, tibial tunnel enlargement was significantly higher within the first 10 weeks, after 10 weeks to 12 months, the bone tunnel diameter remained stable.%目的 观察电子计算机X射线断层扫描技术(CT)测量下自体骨—髌腱—骨(BPTB)前交叉韧带(ACL)重建术后胫骨隧道直径的变化.方法 对52例(52膝)ACL损伤患者行自体BPTB ACL重建术.分别于术后1、10周、12个月用64层螺旋CT对患膝进行扫描,同时进行三维重建.测量胫骨骨隧道关节面下方1 cm、隧道外口上方1 cm及隧道中点的直径,计算骨隧道扩大百分比.结果 52例患者术后1周胫骨隧道扩大11.18％±3.39％,术后10周胫骨隧道扩大25.98％±4.36％,术后12个月为26.24％±4.44％.术后1、10周胫骨隧道扩大百分比相比,P＜0.05,术后10周、12个月相比,P＞0.05.结论 BPTB ACL重建术后胫骨隧道发生扩大,明显扩大发生在术后10周内,术后10周～12个月骨隧道直径比较稳定.