BACKGROUND Graft healing within the femoral tunnel after anterior cruciate ligament reconstruction (ACLR) using suspensory fixation could be reflected in graft maturation and tunnel morphological changes. However, the correlation between graft maturation and femoral tunnel changes remains unclear. PURPOSE To quantitatively evaluate femoral tunnel morphological changes and graft maturation and to analyze their correlation after ACLR using femoral cortical suspension. STUDY DESIGN Case series; Level of evidence, 4. METHODS Patients who underwent single-bundle ACLR with a hamstring tendon autograft using femoral cortical suspension were included. Preoperative and postoperative (at 6, 12, and 24 months) knee function were evaluated using KT-1000 arthrometer testing, the Lysholm knee scoring scale, and the International Knee Documentation Committee (IKDC) questionnaire. At 1 day, 6 months, 12 months, and 24 months after ACLR, 3-dimensional magnetic resonance imaging was performed to observe the morphology of the femoral tunnel and to evaluate graft maturation using the graft signal/noise quotient (SNQ). The Pearson product moment correlation coefficients (r) of femoral tunnel radii versus clinical outcomes and graft SNQs at last follow-up were analyzed. RESULTS A total of 22 patients completed full follow-up. KT-1000 arthrometer, Lysholm, and IKDC scores improved over time postoperatively, but no significant improvement was seen after 12 months (P < .05). The radius of the tunnel containing the graft and the SNQs of the femoral intraosseous graft and intra-articular graft were the highest at 6 months, and they decreased by 24 months but remained higher than their 1-day postoperative values (P < .05). Expansion mainly occurred at the anteroinferior wall of the femoral tunnel. The tunnel aperture radius was positively correlated with SNQs of the intraosseous graft (r = 0.591; P < .05) and intra-articular graft (r = 0.359; P < .05) but not with clinical outcomes. CONCLUSION After ACLR using suspensory fixation, morphological changes of the femoral tunnel were mainly observed in the part of the tunnel containing the graft, which expanded at 6 months and reduced by 24 months. Expansion mainly occurred at the anteroinferior wall of the femoral tunnel. Femoral tunnel expansion was correlated with inferior graft maturation but not with clinical outcomes.

中文翻译：

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股骨皮质悬吊重建前交叉韧带后2年内，股骨隧道的形态变化及其与Ham绳肌腱自体成熟的相关性。

背景技术使用悬吊固定术在前交叉韧带重建（ACLR）后股骨隧道内的移植物愈合可能反映在移植物成熟和隧道形态变化中。然而，移植物成熟与股骨隧道改变之间的相关性仍不清楚。目的定量评估股骨隧道的形态变化和移植物的成熟度，并分析使用股骨皮质悬吊进行ACLR后的相关性。研究设计案例系列；证据等级：4。方法包括使用股骨皮质悬吊进行单束ACLR with绳肌腱自体移植的患者。术前和术后（分别在第6、12和24个月时）使用KT-1000关节压力计测试，Lysholm膝盖评分量表，和国际膝关节文献委员会（IKDC）问卷。在ACLR术后1天，6个月，12个月和24个月，进行3维磁共振成像以观察股骨隧道的形态，并使用移植物信号/噪声商（SNQ）评估移植物的成熟度。分析了最后一次随访时股骨隧道半径的Pearson乘积矩相关系数（r）与临床结局和移植物SNQ的关系。结果共有22例患者完成了完整的随访。术后KT-1000关节硬度计，Lysholm和IKDC评分随时间改善，但12个月后未见明显改善（P <.05）。在6个月时，包含移植物的隧道半径以及股骨骨内移植物和关节内移植物的SNQ最高，减少了24个月，但仍高于术后1天的值（P <.05）。扩张主要发生在股骨隧道的前下壁。隧道孔径半径与骨内移植物的SNQ（r = 0.591; P <.05）和关节内移植物的SNQ（r = 0.359; P <.05）正相关，但与临床结果无关。结论采用悬吊固定进行ACLR后，股骨隧道的形态学变化主要发生在含有移植物的隧道部分，扩张期为6个月，而减少了24个月。扩张主要发生在股骨隧道的前下壁。股骨隧道扩张与移植物成熟度低下有关，但与临床结果无关。扩张主要发生在股骨隧道的前下壁。隧道孔径半径与骨内移植物的SNQ（r = 0.591； P <.05）和关节内移植物的SNQ（r = 0.359; P <.05）正相关，但与临床结果无关。结论采用悬吊固定进行ACLR后，股骨隧道的形态学变化主要发生在含有移植物的隧道部分，扩张期为6个月，而减少了24个月。扩张主要发生在股骨隧道的前下壁。股骨隧道扩张与移植物成熟度低下有关，但与临床结果无关。扩张主要发生在股骨隧道的前下壁。隧道孔径半径与骨内移植物的SNQ（r = 0.591; P <.05）和关节内移植物的SNQ（r = 0.359; P <.05）正相关，但与临床结果无关。结论采用悬吊固定进行ACLR后，股骨隧道的形态学变化主要发生在含有移植物的隧道部分，扩张期为6个月，而减少了24个月。扩张主要发生在股骨隧道的前下壁。股骨隧道扩张与移植物成熟度低下有关，但与临床结果无关。05）和关节内移植（r = 0.359; P <.05），但无临床结果。结论采用悬吊固定进行ACLR后，股骨隧道的形态学变化主要发生在含有移植物的隧道部分，扩张期为6个月，而减少了24个月。扩张主要发生在股骨隧道的前下壁。股骨隧道扩张与移植物成熟度低下有关，但与临床结果无关。05）和关节内移植（r = 0.359; P <.05），但无临床结果。结论采用悬吊固定进行ACLR后，股骨隧道的形态学变化主要发生在含有移植物的隧道部分，扩张期为6个月，而减少了24个月。扩张主要发生在股骨隧道的前下壁。股骨隧道扩张与移植物成熟度低下有关，但与临床结果无关。