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Serial change of femoral and tibial tunnel width after anterior cruciate ligament reconstruction with allograft

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate progressive tunnel widening and its correlation with postoperative outcomes after anterior cruciate ligament (ACL) reconstruction using allografts.

Methods

Sixty-five patients who underwent ACL reconstruction using a tibialis anterior allograft between 2015 and 2017 were enrolled. Femoral and tibial tunnel widths were measured on anteroposterior (AP) and lateral radiographs immediately and at 3, 6, 12, and 24 months postoperatively. Average femoral and tibial tunnel widths in AP and lateral views were calculated at three different measurement points. Tunnel widening was calculated as the difference in tunnel width immediately and 2 years postoperatively. The correlation between tunnel widening and the postoperative results was analysed.

Results

Tunnel width changes between immediate and 2 years postoperatively were as follows, in AP and lateral views, respectively: femur, 3.0 mm ± 1.5 mm and 2.4 mm ± 1.4 mm; and tibia, 2.8 mm ± 1.4 mm and 2.9 mm ± 1.5 mm. Femoral tunnel widths significantly increased until 1 year, but not from 1 to 2 years postoperatively. Tibial tunnel width significantly increased until 2 years postoperatively. In all tunnels, the increments in tunnel widening decreased over time. Increased knee laxity significantly correlated with greater femoral tunnel widening in AP (r = 0.346, P = 0.006) and lateral views (r = 0.261, P = 0.049).

Conclusion

Femoral tunnel widths gradually increased until 1 year postoperatively, and tibial tunnel widths increased until 2 years after ACL reconstruction with allografts. The tunnel widening rate gradually decreased over time. Femoral tunnel widening of 3.7 mm and 3.2 mm on AP and lateral views, respectively, were the cut-off values for postoperative knee laxity.

Level of evidence

Level III.

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Availability of data and materials

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyangsi, Gyeonggido, Korea

    Sung-Sahn Lee

  2. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea

    Dae-Hee Lee

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Correspondence to Dae-Hee Lee.

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The authors declare that they have no conflicts of interest.

Ethical approval

Our institutional review board approved the protocol used to evaluate radiographic findings and intraoperative navigation data (SMC 2022-05-056).

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Lee, SS., Lee, DH. Serial change of femoral and tibial tunnel width after anterior cruciate ligament reconstruction with allograft. Knee Surg Sports Traumatol Arthrosc 31, 5057–5066 (2023). https://doi.org/10.1007/s00167-023-07543-4

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  • DOI: https://doi.org/10.1007/s00167-023-07543-4

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