前十字韧带双束重建术后CT测量骨隧道大小的价值

目的 探讨前十字韧带(ACL)双束重建术后CT测量骨隧道大小的价值.方法 47例单纯ACL断裂自体胭绳肌腱双束重建患者,男42例,女5例;年龄18～52岁,平均26.8岁.采用双束四隧道八股肌腱重建ACL方法 ,隧道外悬吊式固定.术后分别在X线及CT片上测量胫骨、股骨骨隧道的直径,并与术中钻孔值比较.结果 术中胫骨浅束钻孔直径平均(0.5979±0.0521)cm,胫骨深束钻孔直径平均(0.7479±0.0651)cm,股骨浅束钻孔直径平均(0.5734±0.0487)cm,股骨深束钻孔直径平均(0.6947±0.0732)cm.X线测量结果 示:胫骨浅束直径为0.545±0.762 cm,平均(0.6369±0.0638)em;胫骨深束直径为0.601±0.987 cm,平均(0.7784±0.0841)em;股骨浅束直径为0.534±0.644 cm,平均(0.5780±0.0305)cm;股骨深束直径为0.488～0.817 cm,平均(0.6723±0.0754)cm.CT 测量结果 示:胫骨浅束直径平均(0.6009±0.0502)cm,胫骨深柬直径平均(0.7497±0.0677)cm,股骨浅束直径平均(0.5662±0.0375)cm,股骨深束直径平均(0.7002±0.0709)cm.CT 测量值与术中钻孔值比较差异无统计学意义(P＞0.05).结论 CT 测量方法 可以真实反映胫骨、股骨骨隧道大小,适用于ACL重建术后骨隧道扩大的研究.

The value of bone tunnel measured with CT after two-bundle anterior cruciate ligament reconstruction

Objective To discuss the value of bone tunnel measured with CT after two-bundle anterior cruciate ligament reconstruction.Methods Forty-seven patients suffered anterior cruciate ligament (ACL) rupture involved in this study,which included 42 males,5 females,with the mean age of 26.8 years (range,18-52 years).All patients underwent a two-bundle four-tunnel eight-strand autogenous hamstring tendons ACL reconstruction.The diameters of tibia and femur bone tunnel were measured at postoperative X-ray and CT images.Results The mean drilling diameter of the shallow tibia bone tunnel was (0.5979±0.0521)cm; the mean drilling diameter of the deep tibia bone tunnel was (0.7479~0.0651)cm; the mean drilling diameter of the shallow femur bone tunnel was (0.5734 ±0.0487) cm; the mean drilling diameter of the deep femur bone tunnel was (0.6947±0.0732) cm.The data measured at postoperative CT images showed as following: the mean diameter of the shallow tibia bone tunnel was (0.6009±0.0502) cm; the mean diameter of the deep tibia bone tunnel was (0.7497±0.0677) cm; the mean diameter of the shallow femur bone tunnel was (0.5662±0.0375)cm; the mean diameter of the deep femur bone tunnel was (0.7002±0.0709) cm.The data measured at postoperative X-ray images showed as following: the diameter of the shallow tibia bone tunnel was 0.545-0.762 cm,the mean was (0.6369±0.0638)c m; the diameter of the deep tibia bone tunnel was 0.601-0.987 cm,the mean was (0.7784±0.0841)cm; the diameter of the shallow femur bone tunnel was 0.534-0.644 cm,the mean was (0.5780±0.0305) cm; the diameter of the deep femur bone tunnel was 0.488-0.817 cm,the mean was (0.6723±0.0754) cm.There was no significant difference between the measured postoperative tunnel diameter and actual drilling diameter.Conclusion CT scan can measure and represent the actual diameter of the bone tunnel,and is a useful and reliable method to evaluate the enlargement of the bone tunnel after ACL reconstruction.