Comparative study of femoral tunnel enlargement after hamstring anterior cruciate ligament reconstruction with different graft fixations / 中国矫形外科杂志

ABSTRACT

[Objective]To compare the changes in femoral bone tunnel after arthroscopically assisted hamstring ACL reconstruction with different graft fixations and investigate the relation with clinical effect.[Method]Eighty-eight cases in three groups were included and underwent hamstring ACL reconstruction with different femoral graft fixations for average 16.5 months follow-up evaluation.Twenty-six cases in group A received Endobutton fixation,twenty-two cases(group B) received interference screw,and forty cases(group C)received Rigidfix system.Femoral bone tunnel diameters at the articular line level,the widest point,1 cm away from tunnel aperture on sagittal MRI were compared at one week postoperatively.Lysholm score was used to evaluate the clinical effect.[Result]Tunnel enlargement after ACL surgery was noted in the three groups.At the femoral widest point and 1 cm away from tunnel aperture,the tunnel enlargement was larger in group B and smaller in group C.At the femoral articular line level,the bone tunnel enlargement in group C was smallest.There was no difference between those of groups A and B.The shape of femoral tunnel was lineal in groups A and C,and conical in group B.No significant difference was found by Lysholm score.[Conclusion]The type of graft fixation is a major factor in the development of tunnel enlargement after ACL surgery.No correlation between graft fixation,bone tunnel enlargement and clinical effect has been found.