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자가 골 - 슬개건 - 골을 이용한 전방십자인대 재건술 후 공여 슬개건의 형태적 변화
박병철,경희수,인주철,김풍택 대한슬관절학회 1998 대한슬관절학회지 Vol.10 No.1
The use of a central one-third patellar tendon as an autograft for surgical reconstruction of a damaged cruciate ligament is common. However, recent clinical studies indicate that decreased quadriceps strength, decreased range of motion, decreased thigh circumference and patello-femoral problems can be associated with this procedure. Some of these complications may result from alterations in the structural properties of the remaining patellar tendon. The objective of this study was to examine tructural change of the remaining patellar tendon using MRI after removal of its central one-third. We evaluated 10 patients received ACL reconstruction using autogenous central third bone-patellar tendon-bone. The mean age of the patient was 24 years old. The mean follow-up period was 30 months. The surgical technique was arthroscopically assisted ACL reconstruction using single incision. Only paratenon was repaired, reniaining patellar tendon defect. We checked the thickness, width, length and cross-sectional area of patellar tendon defect from axial MR scan. We also checked preoperative MR image of the same patient and compare as control. Paired t-test was used as a statistical analysis. The mean thickness of pre-operation of the patellar tendon was 4.1mm, and 4.9mm of the follow-up(p=0.15). The mean width of pre-operation of the patellar tendon was 30.lmm, and 29.3mm of the follow-up(p=0.37). The mean length of pre-operation of the patellar tendon was 43mm, and 43.5mm of the follow-up(p=0.74). There were no significant differences in thickness, width and length at follow-up. Patellar tendon defect was observed in 7 cases. The mean cross-sectional area of the defect were 10.3㎟±5.5㎟. But 3 cases were completely filled with tendon without defect. The results iridicate that harvesting the central one-third of the patellar tendon does not significant affect the thickness, width and length of the tendon at least 24 months after arthroscopically assisted ACL reconstruction using autogenous central one-third bone-patellar tendon-bone. But patellar teridon defect can be remained in 40 months after surgery. So harvesting of the autogenous central one-third bone-patellar tendon-bone must be carefully performed.
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