单束前交叉韧带重建术后移植物成熟阶段及移植物方向与功能预后的相关性
简介
一项前瞻性研究纳入34例青年患者（20-45岁），行解剖单束ACL重建，术后12个月行MRI检查，测量移植物信号强度比（SIR）和矢状面倾斜角，并与6个月和12个月的IKDC、Lysholm评分进行相关性分析。关键发现：移植物SIR（均值4.63±0.71）显著高于正常ACL（2.95±0.24），42%患者SIR≤4.5（接近正常）；SIR与12个月IKD…
英文摘要
BACKGROUND: Graft maturation and orientation after single-bundle anterior cruciate ligament (ACL) reconstruction influence functional outcomes, but quantitative magnetic resonance imaging (MRI) correlations with validated clinical scores remain underexplored, particularly regarding surgical timing. OBJECTIVE: To correlate 12-month MRI graft signal intensity ratio (SIR) and sagittal graft inclination with International Knee Documentation Committee (IKDC)/Lysholm scores after anatomic single-bundle ACL reconstruction, and assess injury-to-surgery interval effects. METHODOLOGY: Prospective study of 34 young adults (20-45 years) undergoing standardized arthroscopic ACL reconstruction at Rajendra Institute of Medical Sciences, Ranchi, a tertiary care center in Jharkhand, India. 12-month MRI measured SIR (vs. native ACL controls: 2.6-3.4, mean 2.95 ± 0.24) and sagittal inclination. Functional outcomes used IKDC/Lysholm scores at 6 and 12 months. Pearson correlations, t-tests, and multivariate regression analyzed relationships. RESULTS: Graft SIR ranged 3.0-6.0 (mean 4.63 ± 0.71; P < 0.001 vs. native), with 42% ≤ 4.5 (near-native). SIR negatively correlated with 12-month IKDC (r = -0.62, P = 0.004) and Lysholm (r = -0.58, P = 0.007). Sagittal inclination (mean 52.6 ± 3.1°) showed no correlation. Early surgery (≤6 months) yielded lower SIR (4.25 ± 0.56 vs. 4.94 ± 0.68; P = 0.010) and higher IKDC (87.9 ± 4.4 vs. 79.8 ± 6.0; P = 0.012). Multivariate analysis confirmed SIR (β = -0.47, P = 0.009) and timing (β = -0.29, P = 0.038) independently predicted IKDC (R2 = 0.54). CONCLUSION: Lower 12-month graft SIR strongly predicts better functional outcomes after single-bundle ACL reconstruction. Earlier surgery enhances maturation; sagittal inclination within anatomical limits lacks impact. Quantitative MRI complements clinical assessment for rehabilitation planning.