ABSTRACT
After reconstruction of anterior cruciate ligament, increased idameter of femoral or tibia1 bone tunnel has been obsened on plain radiogram. The etiology of radiographic tunnel enlargement is not well understood and the significance of this tunnel enlargement is unknown. This retrospective study reviewed tibial tunnel diameter in 34 cases of anterior cruciate ligament reconstructions. And we evaluated the correlation between the tibial tunnel enlargement and the position of screw fixation, instability, choice of graft, and clinical results at 1 year postoperatively. AII operation was per formed using a single incision technique. After 3 or 4 months and one year after operation, the diameter of tibial tunnel was measured with digital caliper on the plain radiogram. Tibial tunnel sclerotic margins were measured in the level Of medial tibial plateau on the lateral view of knee. Average tunnel enlargement of 3 allografts was 1.62mm and that of 15 autografts was 2.03mm. No significant difference was seen in KT-10000 arthrometer measurements between enlarged group (amount of enlage-ent >+1 S.D) and not-enlarged group (less than +1 S.D). No coelation was present between the increased tunnel diameter and Lysholm score. Cases with 10mm or more vertical distance between the most proximal point of tihial interference screw and the level of m4eial tibial plateau had average 1.15mm tibial tunnel enlargement and cases with less than 10mm vertical distance ha & I average 2.52mm tibial tunne] enlargement;the difference was not significant (P>0.05). The tibial tunnel enlargement was not correlated with position of screw, clinical results, stability of knee. The tibial tunnel enlargement was not caused hy only mechanical factor such as motion of intra-tunnel portion of graft-tendon.
Subject(s)
Allografts , Anterior Cruciate Ligament , Autografts , Knee , Retrospective Studies , TransplantsABSTRACT
The roentgenograms following arthroscopic ACL reconstruction show the enlargement of bone tunnels. Many authors hypothesized the cause of the tunnel enlargement, either mechanical or biological causes. The purpose of this study was to find the factors which affected the enlargement of the tibial tunnel following arthroscopic ACL reconstruction with bone-patellar tendon-bone or hamstring tendon. Sixty patients were reviewed retrospectively for radiographic measurement of tibial tunnel at post-operative one year (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device, 21 patients received Semitendinosus and Gracilis tendons with Endobutton). Roentgenographic anteroposterior and lateral films were checked and the tunnel was measured by two independent observers using a digital caliper. Statistical analysis was performed using a one-way analysis of variance (ANOVA) and t-test. The tibial tunnel enlargement was only related to the position of the fixation of the tibial tunnel. We concluded that tibial tunnel enlargement following arthroscopic ACL reconstruction is attributed to the mechanical effect rather than the properties of grafts and the clinical results.