All-soft tissue quadriceps tendon autograft and bone-patellar tendon-bone autograft demonstrate no significant ACL tunnel widening: An MRI comparison.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-20 DOI:10.1002/ksa.12479

Cody C Ashy, Mary-Katherine Lynch, Henry B G Baird, John W Xerogeanes, William Pullen, Harris S Slone

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引用次数: 0

Abstract

Purpose: This study sought to quantify the tunnel widening associated with quadriceps tendon (QT) autograft after anterior cruciate ligament reconstruction (ACLR) and compare it to bone-patellar tendon-bone (BTB) autografts.

Methods: A retrospective review of each ACLR performed at a single academic institution from 2011 to 2021 were reviewed. Subjects with repeat ipsilateral knee magnetic resonance imaging (MRI) studies performed after ACLR were included. Two reviewers independently measured the maximum diameter of the femoral and tibial tunnels 1 cm from the aperture. Tunnel widening was calculated as the difference between the initial drilled diameter and the measured diameters.

Results: Seventy-five patients (38 BTB and 37 QT autografts) were identified including 42 females and 33 males. With respect to graft type (QT vs. BTB), there was no statistically significant difference in median patient age (19.0 (16.0-31.5) years vs. 20.0 (16.8-30.0) years respectively; p = n.s.) or median time to MRI (12.0 [9.0-19.5] months vs. 13.0 [7.0-43.3] months respectively, p = n.s.). Mean tunnel diameter changes or widening was statistically significantly greater for QT autografts than BTB autografts at the tibial tunnel: (0.4 [±0.6] mm] vs. -0.4 [±1.1 mm; p < 0.001). Similarly, the mean tunnel diameter change was also significantly greater at the femoral tunnel for QT compared to BTB. (0.2 [±0.6] mm vs. -0.4 [±0.8] mm; p < 0.001) However, no patients with QT grafts demonstrated tibial or femoral tunnel diameters >12 mm.

Conclusion: Although QT autografts had a statistically significant greater amount of tunnel widening compared to BTB autografts; the mean tibial and femoral net widening of 0.4 mm and 0.2 mm, respectively, does not meet previously reported clinically significant values. Thus, the tunnel widening presented in this study is unlikely to affect clinical outcomes and should not preclude the use of either graft.

Level of evidence: Level III (Retrospective comparative study).

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全软组织股四头肌腱自体移植和骨-髌腱-骨自体移植均未显示出明显的前交叉韧带隧道增宽：核磁共振成像对比。

目的：本研究旨在量化前交叉韧带重建（ACLR）术后与股四头肌腱（QT）自体移植物相关的隧道增宽，并将其与骨-髌腱-骨（BTB）自体移植物进行比较：方法：对 2011 年至 2021 年在一家学术机构进行的每例 ACLR 进行回顾性研究。方法：对 2011 年至 2021 年期间在一家学术机构进行的每一次前交叉韧带置换术进行回顾性审查。两名审查员独立测量股骨和胫骨隧道距孔径 1 厘米处的最大直径。隧道增宽按初始钻孔直径与测量直径之差计算：确定了 75 例患者（38 例 BTB 和 37 例 QT 自体移植物），其中女性 42 例，男性 33 例。就移植类型（QT 与 BTB）而言，患者的中位年龄（分别为 19.0 (16.0-31.5) 岁 vs. 20.0 (16.8-30.0) 岁；p = n.s.）或磁共振成像的中位时间（分别为 12.0 [9.0-19.5] 个月 vs. 13.0 [7.0-43.3] 个月；p = n.s.）无统计学差异。在胫骨隧道，QT自体移植物的平均隧道直径变化或增宽在统计学上明显大于BTB自体移植物：（0.4 [±0.6] mm] vs. -0.4 [±1.1 mm; p 12 mm）：结论：虽然 QT 自体移植物与 BTB 自体移植物相比，在统计意义上具有更大的隧道增宽量，但胫骨和股骨的平均净增宽量分别为 0.4 毫米和 0.2 毫米，并未达到之前报道的具有临床意义的数值。因此，本研究中出现的隧道增宽不太可能影响临床结果，也不应排除使用这两种移植物：证据等级：三级（回顾性比较研究）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).