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International Orthopaedics

, Volume 31, Issue 1, pp 49–55 | Cite as

Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study

  • Raffaele Iorio
  • Antonio Vadalà
  • Giuseppe Argento
  • Vincenzo Di Sanzo
  • Andrea Ferretti
Original Paper

Abstract

Purpose: To evaluate prospectively the increase in the size of the tibial and femoral bone tunnel following arthroscopic anterior cruciate ligament (ACL) reconstruction with quadrupled-hamstring autograft. Methods: Twenty-five consecutive patients underwent arthroscopic ACL reconstruction with quadrupled-hamstring autograft. Preoperative clinical evaluation was performed using the Lysholm knee score, Tegner activity level, and International Knee Documentation Committee forms and a KT-1000 arthrometer (side to side). Computed tomography (CT) of the femoral and tibial tunnel was performed on the day after operation in all cases and at mean follow-up of 10 months (range 9–11 months).Results: All of the clinical evaluation scales performed showed an overall improvement. The postoperative anterior laxity difference was <3 mm in 16 patients (70%) and 3–5 mm in seven patients (30%). The mean average femoral tunnel diameter increased significantly (3%) from 9.04±0.05 mm postoperatively to 9.3±0.8 mm at 10 months; tibial tunnel increased significantly (11%) from 9.03±0.04 mm to 10±0.8 mm. There were no statistically significant differences between tunnel enlargement, clinical results, and arthrometer evaluation. Conclusions: The rate of tunnel widening observed in this study seems to be lower than that reported in previous studies that used different techniques. We conclude that an anatomical surgical technique and a less aggressive rehabilitation process influenced the amount of tunnel enlargement after ACL reconstruction with doubled hamstrings.

Keywords

Anterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Patellar Tendon Femoral Tunnel Tibial Tunnel 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

But: Évaluer prospectivement l’augmentation de taille des tunnels osseux après reconstruction arthroscopique du LCA par les ischio-jambiers. Méthode: 25 patients avaient été opérés. L’évaluation pré-opératoire avait été faite avec le score de Lysholm, les critères IKDC et de niveau d’activité Tegner et la mesure bilatérale avec l’arthromètre KT-1000. Un scanner des tunnels était réalisé dans tous les cas le jour suivant la chirurgie et à un suivi moyen de 10 mois (9–11). Résultats: Tous les scores cliniques montraint une amélioration globale. La différence de laxité antérieure après l’intervention était de moins de 3mm pour 16 patients (70%) et de 3 à 5 mm pour 7 (30%). Le diamètre moyen du tunnel fémoral augmentait significativement (3%) de 9,04±0,05 mm en post-opératoire à 9,3±0,8 mm à 10 mois ; le tunnel tibial augmentait (11%) de 9,03±0,004 à 10±0,8 mm. Il n’y avait pas de corrélation significative entre l’élargissement des tunnels, les résultats cliniques et les mesures à l’arthromètre. Conclusions: La proportion d’élargissement des tunnels observée dans cette étude semble plus faible rapportées avec des techniques différentes. Nous pensons qu’une technique très anatomique et une rééducation peu agressive influence l’élargissement des tunnels dans la reconstruction du LCA par les ischio-jambiers.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Raffaele Iorio
    • 1
  • Antonio Vadalà
    • 1
  • Giuseppe Argento
    • 2
  • Vincenzo Di Sanzo
    • 1
  • Andrea Ferretti
    • 1
    • 3
  1. 1.Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, S. Andrea HospitalUniversity of Rome “La Sapienza”RomeItaly
  2. 2.Radiology Unit, S. Andrea HospitalUniversity of Rome “La Sapienza”RomeItaly
  3. 3.RomaItaly

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