Tibial Tunnel Changes after Arthroscopic ACL Reconstruction using Autogenous Bone-Patellar Tendon-Bone

ABSTRACT

PURPOSE: We analysed radiographic changes of bone tunnels after anterior cruciate ligament(ACL) reconstruction and evaluated the correlation between measurements and clinical variable. MATERIALS AND METHODS: Fifty patients were examined retrospectively. The interval between surgery and examination ranged from 12 to 48 months with a mean of 18 months. We measured the area and width of tibial tunnel from the radiographs of anteroposterior(AP) and lateral views of the knee after arthroscopic ACL reconstruction using computer program "Image-Pro ExpressRfi". The proximal, middle, distal one third of tibial tunnel area and maximum diameter of tibial tunnel were measured on AP and lateral radiographs. Each measurements were done on immediate postoperative, and postoperative 3, 6, 9, 12, 24, 36 months. RESULTS: The size of tibial tunnel was larger on lateral than AP radiograph. The proximal part was found to be the largest and the size decreased as it moved distally. The area of proximal one third was increased from postoperative 3 months and that of distal one third was decreased from postoperative 3 months. The shape of tibial tunnel area on the last follow-up was cylinder type in 33(66%) and 17(34%) on AP and lateral radiograph, mallet type 8(16%) and 4(8%), reverse bottle type 5(10%) and 11(22%), reverse triangle type 4(8%) and 18(36%) respectively. CONCLUSIONS: The tibial tunnel change was not correlated with clinical variable such as Lysholm score.