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Analysis of tunnel widening after double-bundle ACL reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the tunnel widening using a multi-planar reformation of MRI (Magnetic Resonance Imaging) in the orientation of the tunnel. The hypotheses of this study were as follows: (1) tunnel widening would be reduced with the above-mentioned technique, (2) the degree of tunnel widening would be different at the site of the tunnels, and (3) the time interval from surgery to MRI acquisition would affect the magnitude of tunnel widening.

Methods

Forty double-bundle ACL reconstructed patients who underwent postoperative MRI were enrolled in this study. The postoperative MRI was performed at 26.7 ± 7.4 months in terms of time. The tunnel widening was examined using a multi-planar reformation of MRI in the orientation of the tunnel. Site-specific analysis was performed according to the depth (the entrance, mid, and exit portion) and wall (anterior, posterior, medial, and lateral walls). The correlation between MRI and widening was also evaluated.

Results

The mean tunnel widening of the femoral AM (Anteromedial), femoral PL (Posterolateral), tibial AM, and tibial PL in terms of the most widened diameter was 1.9 (25.4), 2.1 (30.8), 2.5 (32.8), and 3.2 mm (44.5%), respectively. The tibial PL tunnel showed significant widening than the other tunnels. At the entrance, tunnel widening occurred mostly, followed by the order of the mid and exit portion. Correlation analysis of the time interval of MRI acquisition and tunnel widening showed little association.

Conclusions

Tunnel widening after a double-bundle ACL reconstruction using an outside-in technique with press-fitting of the graft was acceptable compared to previously published studies. The tibial PL tunnel showed the most widening among the 4 tunnels examined with the tunnel entrance being most widened area.

Level of evidence

Therapeutic case series, Level IV.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Gil Hospital, Gachon University School of Medicine, Incheon, Korea

    Yong Seuk Lee, Shin Woo Nam, Won Seok Oh, Jae Ang Sim, Ji Hoon Kwak & Beom Koo Lee

  2. Department of Radiology, Gil Hospital, Gachon University School of Medicine, Incheon, Korea

    Sheen-Woo Lee

  3. Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea

    Beom Koo Lee

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  1. Yong Seuk Lee
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  2. Sheen-Woo Lee
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Correspondence to Beom Koo Lee.

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Lee, Y.S., Lee, SW., Nam, S.W. et al. Analysis of tunnel widening after double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 20, 2243–2250 (2012). https://doi.org/10.1007/s00167-011-1874-5

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  • DOI: https://doi.org/10.1007/s00167-011-1874-5

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