ABSTRACT
BACKGROUND: Femoral and tibial tunnel widening (TW) after ACL reconstruction is a phenomenon increasing talk in the literature. It is underlying biological and mechanical causes. OBJECTIVE: The aim of this study was to evaluate the relationship between bone tunnel enlargement and two different ACL fixation systems. PATIENTS AND METHODS: 40 patient underwent ACL reconstruction with hamstring; randomly divided into group A with 20 patients treated with stiff systems (femoral Rigidfix and tibial interference screw), and into group B, with 20 patients treated with morel elastic system (femoral and tibial Tight-rope). Evaluated postoperatively with knee MRI at 40 days, 3 months, 6 months to measure bone tunnel diameters widening. RESULTS: At 40 days tunnel widening between two groups shows no statistically difference. At 3 months postoperatively, femoral bone tunnel widening amounted on average to 1.84 mm in middle of tunnel and 1 mm at the mouth in joint in group A, and respectively 3.2 mm and 2.5 mm in group B (p<0.05). Tibial tunnel widening was 1.24 mm at the mouth in joint and 1.3 mm in middle in group A and respectively 2.26 mm and 2.43 mm in group B (p<0.05). At 6 months femoral tunnel widening amounted on average to 2.45 mm in middle and 1.35 mm at the mouth in joint in group A and respectively 3.5 mm and 2.7 mm in group B (p<0.01). Tibial tunnel widening amounted on average to 1.27 at mouth in joint and 1 mm in middle of tunnel in group A and respectively 2.6 mm and 2.3 mm in group B (p<0.01). CONCLUSIONS: This study results suggest elastic fixation system increases bone tunnel enlargement after ACL reconstruction with hamstring without correlation with worse clinical performance. LEVEL OF EVIDENCE: IV.
ABSTRACT
The technology of optical 3D imaging sensors or 3D scanners (laser and structured light sensors) has become widely available over the last few years. A wider diffusion of this technique in anatomical laboratories could lead to a revolution in the field of anatomy: cadaver dissections could be easily documented in 3D, and specimens stored in museums could be easily scanned and the 3D models shared. In the present article, a simple, versatile, economical and widespread 3D scanner, the Kinect sensor, is validated to show its potential use for 3D scanning of anatomical specimens. The comparison of 3D models of anatomical specimens (a collection of skulls) with the respective 2D photographs showed that 3D models were superior to the photographs, the latter being affected by some distortions due to perspective. Moreover, the 3D models allowed for measuring angles, distances, circumferences between every part of the model, or measuring volumes and surfaces, which, of course, were not available using the 2D images. Due to the low cost of this system, its simplicity of use and its widespread availability, it is desirable that in the future, anatomical specimens from museums will become more available as 3D objects. These could greatly simplify the quantitative analysis of rare specimens, such as fetal monstrosities or anatomical variations
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