股骨骨道位置对前交叉韧带术后半年腘绳肌腱移植物信噪比的影响  

The Relationship Between ACL Femoral Tunnel Position and the Signal-to-noise Quotient of Hamstring Tendon Grafts 6 Months after the Operation

作　　者：马勇[1] 张家豪[1] 蒋艳芳[1] 王海军[1] 王永健[1] 王健[1] 敖英芳[1] Ma Yong;Zhang Jiahao;Jiang Yanfang;Wang Haijun;Wang Yongjian;Wang Jian;Ao Yingfang(Institute of Sports Medicine,Third Hospital of Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院运动医学研究所

出　　处：《中国运动医学杂志》2019年第6期469-473,共5页Chinese Journal of Sports Medicine

基　　金：北京市科学技术委员会:首都临床特色应用研究项目(编号:Z161100000516034)

摘　　要：目的:观察前交叉韧带(ACL)重建术后半年腘绳肌腱移植物磁共振成像(MRI)信噪比特点,分析股骨骨道位置对其影响。方法:2015年10月至2018年6月,154名患者接受关节镜下ACL重建手术。股骨骨道均为经前内入路制作。依据股骨骨道位置,分成近前内束(AM)组和近解剖中心(Center)组。术后半年,患膝关节行MRI检查。选取关节腔内移植物近端、中段、远端三部位计算信噪比(SNQ)。分析两组SNQ的差异。结果:研究纳入99名患者,其中AM组56名,Center组43名。术前两组患者一般资料无差异(P>0.05)。AM组SNQ移植物近、中、远端分别为3.52±1.08、2.43±0.52、1.53±0.61。Center组SNQ移植物近、中、远端分别为3.68±1.52、3.02±0.82、1.55±0.43。组内三部位之间有显著差异。组间比较,近、远端SNQ无差异。AM组中段SNQ较Center组有优势(P=0.023)。结论:ACL重建术后半年,腘绳肌腱移植物关节腔内远端韧带化程度最好,中段次之。较之近解剖中心,将股骨骨道定于近前内束的移植物中段韧带化程度更好。Objective To measure the magnetic resonance image(MRI) signal-to-noise quotient(SNQ) of hamstring tendon grafts at half a year after the anterior cruciate ligament(ACL) reconstruction and analyze the effect of the femoral tunnel position on it. Methods Totally 154 patients undergoing the arthroscopic ACL reconstruction between October 2015 and June 2018 were selected. In all cases,the femoral tunnel was made through the antero-medial portal. The patients with the femoral tunnel located near the anteromedial bundle were selected into the AM group,while those with the tunnel near the center of insertion site were chosen into the the center group. Six months after the surgery,the affected knee joints were examined using MRI. The SNQ at the proximal,middle and distal parts of the graft within the joint cavity was calculated,and compared between the two groups. Results The study included 99 patients, including 56 in the AM group and 43 in the center group.There was no significant difference between the two groups in all the measurements before the surgery(P>0.05). The SNQ of the proximal,middle,and distal ends of the grafts in the AM group was 3.52± 1.08,2.43 ± 0.52 and 1.53 ± 0.61,respectively,showing significant differences among themselves,so was that of the center group(3.68 ± 1.52,3.02 ± 0.82 and 1.55 ± 0.43 accordingly). Moreover,significant differences were observed between the two groups in the SNQ of the middle part(P=0.023),but not of the proximal or distal part. Conclusion At six months after ACL reconstruction,the distal end of the hamstring tendon graft achieved the best healing,followed by the middle part. The femoral tunnel positioned near the anteromedial bundle achieves better healing in the middle part of the graft,compared to those positioned near the center of the insertion site.

关 键 词：前交叉韧带 股骨骨道 移植物 韧带化 MRI 

分 类 号：R687.4[医药卫生—骨科学]