前交叉韧带重建术后并发症的MR征象及原因分析

The Analysis of MR Manifestations and Etiologies of Complications after Anterior Cruciate Ligament Reconstruction

目的分析前交叉韧带重建(ACLR)术后并发症的MR征象及其原因。方法搜集2014年1月至2021年12月因前交叉韧带(ACL)断裂于本院行ACLR术后出现并发症的患者76例作为研究对象,所有患者均采用单束自体腘绳肌腱ACLR。分析损伤-手术间隔时间、骨隧道位置和移植物直径是否对ACLR术后并发症的发生有影响。结果发现90个移植物并发症,撕裂、骨道囊肿、撞击、关节纤维化、感染和黏液样变分别占41.11%、21.11%、14.44%、14.44%、6.67%、2.22%。90个移植物慢性期并发症(55.56%)多于急性期并发症(44.44%),差异有统计学意义(χ^(2)=20.297,P<0.001)。90个移植物并发症中发现骨道偏移35个(38.89%),其中以撕裂合并骨道偏移最多,高达21个(23.33%)。并发症中移植物直径为6 mm、7 mm、8 mm的分别为18个(20.00%)、62个(68.89%)、10个(11.11%)。结论MRI是ACLR术后临床随访中并发症诊断的重要手段,骨隧道位置和移植物直径是预测ACLR失败的危险因素,急性期行ACLR的患者术后并发症的发生率较低。

Objective The analysis of MR manifestations and etiologies of complications after anterior cruciate ligament reconstruction.Methods A total of 76 patients with complications after ACLR due to anterior cruciate ligament(ACL)rupture in our hospital from January 2014 to December 2021 were collected as the research objects.All patients were treated with single bundle autogenous hamstring tendon ACLR.To analyze the effect of injury-operation interval,bone tunnel location and graft diameter on the occurrence of complications after ACLR.Results There were 90 graft complications,including tear(41.11%),bone tract cyst(21.11%),impingment(14.44%),joint fibrosis(14.44%),infection(6.67%)and myxoid degeneration(2.22%).There were more chronic complications(55.56%)than acute complications(44.44%)in 90 grafts,and the difference was statistically significant(χ^(2)=20.297,P<0.001).Among the 90 graft complications,35(38.89%)of bone tract deviation were found,among which 21(23.33%)of tears combined with bone tract deviation were found.Among the complications,18(20.00%),62(68.89%)and 10(11.11%)graft diameters were 6 mm,7 mm and 8 mm,respectively.Conclusion MRI is an important method for the diagnosis of complications in the clinical follow-up after ACLR.Bone tunnel location and graft diameter are risk factors for predicting ACLR failure,and the incidence of postoperative complications of ACLR may be reduced in the acute phase.