经胫骨隧道与前内入路建立股骨骨道早期变化的差异

The differences of the early femur tunnel variation between the transtibial and the anteromedial portal

目的比较分析经胫骨隧道与前内入路两种方式建立股骨骨道早期变化的差异,探讨相关的影响因素。方法对94例患膝关节在关节镜下单束重建前交叉韧带,A组(42例)经胫骨隧道建立股骨隧道,B组(52例)经前内侧入路建立股骨隧道。重建后用相同的方法进行康复锻炼,术后1周和6个月复查X线片了解骨道情况。结果 A组38例、B组42例完成X线检查。术后骨道增宽的发生率两组比较差异无统计学意义(P>0.05);术后骨道增宽的程度A组较B组明显,差异有统计学意义(P=0.001)。结论两种入路建立的股骨股道术后早期均具有较高的骨道扩大发生率,经前内侧入路行ACL重建更有利于减轻股骨骨道的扩大。

Objective To compare the difference of the bone tunnel variation betweent the transtibial（ TT） group and the anteromedial（ AM） portal group,and explore the factors causing the bone tunnel enlargement. Methods The 94 cases with ACL rupture were divided into two groups： Group A（ 42 cases） were reconstructed arthroscopically through transtibial portal technique; Group B（ 52 cases） were reconstructed arthroscopically through anteromedial portal technique. A uniform postoperative rehabilitation protocol was employed for every patient. The diameter and the shape of bone tunnel were measured by using X-ray. X-ray of all cases was taken a week after the reconstruction and in the sixth month. Results 38 cases of group A and 42 cases in group B had been received X-ray examination.Compared group A with group B,the incidence rates of the tunnel enlargement had no statistical difference（ P 0. 05）. However,the extent of the tunnel enlargement had significant statistical difference（ P = 0. 001）. The tunnel enlargement of the group A was bigger. Conclusions The incidence rate of early tunnel enlargement is a little high using the endobutton. It may help to reduce the tunnel enlargement by using the AM portal technique.