胫骨隧道位置不良是前交叉韧带重建术后远期骨关节炎的危险因素：一项回顾性研究
简介
本研究回顾性分析76例ACL重建患者，平均随访10.4年，通过术后三维CT评估骨道位置，并依据IKDC分级判断影像学骨关节炎。结果显示，18.4%的患者出现晚期骨关节炎（IKDC C/D级）。骨道位置不良分布为：股骨侧30.3%，胫骨侧前后位（AP）偏移17.1%，内外侧（ML）偏移19.7%，AP+ML联合偏移11.8%，AP+ML+股骨联合偏移5.3%。…
英文摘要
PURPOSE: This study aimed to compare long-term radiographic OA development after ACLR according to tunnel positioning assessed on 3D postoperative CT scans. METHODS: Tunnel positioning was studied using 3D reconstructions, and tunnels were considered malpositioned if femoral tunnels were classified as type II or III (F), and tibial tunnels had an anteroposterior (AP) gap ≥ 5 mm and/or a mediolateral (ML) gap ≥ 2 mm compared to the native ACL location. Advanced radiographic OA was stages C and D according to the IKDC classification. RESULTS: In this retrospective study, 76 consecutive patients who underwent ACLR were evaluated at a mean follow-up of 10.4 years. The mean age was 34.0 years. At the last follow-up, 18.4% of the patients had an advanced radiographic stage of OA. The distribution of malpositioned tunnels was as follows: 30.3% F, 17.1% AP, 19.7% ML, 11.8% AP+ML, and 5.3% AP+ML+F. There was a significant association between AP+ML (p = 0.022) and AP+ML+F (p < 0.001) tunnels and the IKDC C/D group. CONCLUSION: The malpositioning of tibial tunnels, specifically the combination of ML and AP displacement, is significantly associated with an advanced radiographic stage of OA at a follow-up of 10 years, regardless of femoral tunnel malposition. LEVEL OF EVIDENCE: Level II.