International Orthopaedics

, Volume 30, Issue 2, pp 99–103

Evaluation of tibial bone-tunnel changes with X-ray and computed tomography after ACL reconstruction using a bone-patella tendon-bone autograft

Original Paper

Abstract

Thirteen patients who underwent anterior cruciate ligament (ACL) reconstruction with bone-patella tendon-bone autografts (BTB) using interference screws were the subjects of this study. We analysed the relationship between bone-tunnel changes and clinical results 2 years after ACL reconstruction. To investigate changes, X-ray images were used to evaluate bone-tunnel enlargement, and computed tomography (CT) was used to evaluate the sclerotic area around the bone tunnel. The KT-2000 was used to measure the discrepancy of tibial anterior displacement between the affected and nonaffected sides (DTAD). There was no correlation between bone-tunnel enlargement and DTAD. On the other hand, in the CT evaluation, there was a significant correlation between the sclerotic area and DTAD. Our results suggest that it is more significant to analyse the area of sclerotic change than bone-tunnel enlargement for clinical evaluation. We cannot evaluate bone-tunnel changes correctly with two-dimensional X-rays and cannot analyse the sclerotic area using X-rays. Therefore, we recommend that CT, with which it is possible to analyse the sclerotic area, be used to evaluate bone-tunnel changes and clinical results.

Résumé

13 patients ayant bénéficié d’une reconstruction du ligament croisé antérieur avec une auto-greffe à partir de la rotule et du tendon rotulien par des vis d’interférence ont été le support de cette étude. Nous avons utilisé la relation entre les modifications des tunnels osseux et les résultats cliniques deux ans après la reconstruction du ligament croisé antérieur. Afin d’analyser les modifications au niveau du tunnel osseux, les images radios montrant un élargissement au niveau du tunnel osseux ont été utilisées de même que le scanner afin d’évaluer également la sclérose osseuse autour du tunnel. Les résultats cliniques ont été analysés à l’aide du KT 2000 mesurant le tiroir intérieur entre les deux genoux (genou normal, genou opéré). Il n’y a aucune corrélation entre l’élargissement du tunnel osseux et des modifications du tiroir intérieur, d’autre part, lors de l’évaluation par scanner, il existait une relation significative entre l’aspect sclérotique du tunnel et les modifications de tiroir. Notre étude nous permet de suggérer, qu’il est plus utile d’analyser la sclérose du tunnel plutôt que son élargissement. Il n’est pas possible d’évaluer les modifications du tunnel osseux avec une radio face/profil de même en ce qui concerne l’os scléreux. C’est pour cette raison que nous recommandons l’utilisation du scanner qui permet cette analyse de façon précise et qui permet par ailleurs de faire la relation entre ces modifications et les résultats cliniques.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryIchihara Hospital Teikyo UniversityIchiharashiJapan
  2. 2.Department of AnatomyFaculty of Medicine Kanazawa UniversityKanazawaJapan

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