Advertisement

Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons

  • Hiroyuki Segawa
  • Go Omori
  • Shigeru Tomita
  • Yoshio Koga
Knee

Abstract

We retrospectively reviewed 87 anterior cruciate ligament reconstructions using autogenous hamstring tendons with the Endobutton technique to investigate the relationship between bone tunnel enlargement and clinical outcome and to identify factors that contribute to the enlargement. The clinical outcome was evaluated using the Lysholm score and KT-1000 arthrometer. The location of the femoral tunnel with respect to Blumensaat's line, the tibial tunnel with respect to the tibial plateau, and the angle between the femoral tunnel and Blumensaat's line (femoral tunnel angle) were measured. Bone tunnel enlargement was observed in 32 patients (37%). Enlargement occurred in 22 of the femoral tunnels and 26 of the tibial tunnels. Enlargement of both tunnels occurred in 16 knees. There was no statistical difference in Lysholm scores or KT-1000 arthrometer measurements between the enlarged group and the unenlarged group. The femoral tunnel was placed more anteriorly in the enlarged femoral tunnel group than in the unenlarged femoral tunnel group. The tibial tunnel was placed more anteriorly in the enlarged tibial tunnel group than in the unenlarged tibial tunnel group. The femoral tunnel angle was significantly smaller in the enlarged femoral tunnel group than in the femoral unenlarged group. Gender, patient age, intraoperative isometricity, and graft size were not significant factors. Bone tunnel enlargement was not correlated with the clinical outcome measures. We conclude that the main factor associated with tunnel enlargement are the locations and angles of the tunnels. The windshield-wiper motion of the graft may be enhanced by changing tension in the graft due to tunnel malposition. An acute femoral tunnel angle may increase the mechanical stress on the anterior margin of the femoral tunnel.

Anterior cruciate ligament reconstruction Hamstring tendon Bone tunnel enlargement Tunnel position Tunnel angle 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Hiroyuki Segawa
    • 1
  • Go Omori
    • 1
  • Shigeru Tomita
    • 1
  • Yoshio Koga
    • 2
  1. 1.Department of Orthopedic Surgery, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City, Niigata 951-8510Japan
  2. 2.Department of Orthopedic Surgery, Niigata Kobari Hospital, Kobari, Niigata City, Niigata 950-2002Japan

Personalised recommendations