CT和X线测量前交叉韧带单束重建术后骨道宽度的临床观察

Measurement of bone tunnel width with computed tomography versus plain radiography after anterior cruciate ligament single-bundle reconstruction

目的比较前交叉韧带重建2年后应用CT和X线测量骨道宽度的差异。方法选择前交叉韧带自体胭绳肌腱单束重建术后的患者20例，男10例，女10例，随访时间均在2年以上，平均26（24～31）个月。分别用CT和X线片测量胫骨和股骨骨道在矢状位和冠状位上垂直于骨道纵轴的最大宽度，对所得数据进行统计学分析。结果1例患者CT测量的矢状位和冠状位的胫骨骨道宽度都减小，其余患者的矢状位和冠状位的骨道宽度均增大。采用X线测量的胫骨骨道宽度在冠状位上比CT测量的大（0．9±0．6）（0．3—2．2）mm，在矢状位上比CT大（0．9±0．5）（0．1—2．1）mm，两种测量方法的差异有统计学意义（P〈0．01）。2例患者cT和x线测量的股骨骨道在矢状位和冠状位的宽度均减小，其余患者股骨骨道在矢状位和冠状位的骨道宽度均增大。采用X线测量的股骨骨道宽度在冠状位上比CT大（0．7±0．6）（0—1．7）mm，在矢状位上比CT大（0．94-0．7）（0．1～2．7）mm，两种测量方法的差异有统计学意义（P〈0．01）。结论前交叉韧带重建术后CT和X线两种测量骨道宽度的方法的差异有统计学意义，X线测量值比CT大。

Objective To compare the measurements of bone tunnel width with computed tomography （CT） and plain radiography two years after anterior cruciate ligament single-bundle reconstruction. Methods Twenty patients underwent primary anterior cruciate ligament single-bundle reconstruction with hamstring autografts. There were 10 females and 10 males. Tibial and femoral bone tunnel widths were measured with CT and plain radiography at least two years post-operation. The average follow-up period was 26 months （range, 24 -31 ）. The tunnel measurements were taken at the widest point of tibial and femoral tunnels on sagittal and coronal CT and plain radiography perpendicularly to the longitudinal axis of tunnels. All data were statistically analyzed. Results The tibial tunnel width of one case decreased on CT while all others increased. The average tibial tunnel width on coronal plain radiography was 0. 9 ± 0. 6 mm （ range, 0. 3 - 2. 2） larger than that on CT. And the average width on sagittal plain radiography was 0. 9 ± 0. 5 mm （range, 0. 1 -2. 1 ） larger than that on CT. Both were statistically significant. All femoral tunnel widths increased, except in 2 cases. The average femoral tunnel widths on coronal and sagittal plain radiography were both significantly larger than those on CT. And the difference were 0.7 ± 0. 6 mm （ range, 0 - 1.7 ） and 0. 9 ± 0. 7 mm （ range, 0. 1 - 2.7 ） respectively. Conclusion Bone tunnel measurements on plain radiography are significantly larger than those on CT after anterior cruciate ligament reconstruction.