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Does bone impaction technique reduce tunnel enlargement in ACL reconstruction?

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Abstract

The aim of this study was to investigate effects of bone impaction technique on tunnel enlargement after ACL reconstruction at a minimum 2 years follow-up. Two groups of patients who had been operated upon with the same arthroscopic technique with the exception of tibial tunnel constitution were compared. Twenty-one patients of group A (drilling to 6 mm followed enlargement to 8–9 mm by using dilators) and 23 patients of group B (directly drilling to the size of the graft) were evaluated clinically and radiographically based on multislice computerised tomography (MSCT) retrospectively. At follow-up, there was no statistical difference between tunnel diameters between two groups at the femoral site, but significant difference at the tibial site (p = 0.00192 for coronal; p = 0.0171 for sagittal diameter). Both groups were comparable according pre- and postoperative Lysholm and IKDC scores (p < 0.5 Mann-Whitney U test). Compacted tunnel walls may resist enlargement, suggesting this technique resulted in better tunnel diameter values especially with intratunnel fixation.

Résumé

Le but de cette étude est d’analyser à 2 ans de recul les effets de la greffe osseuse impactée sur l’élargissement du tunnel, lors de la réfection du LCA. Deux groupes de patients ont été opérés par la même technique arthroscopique, nous avons comparé ces deux groupes. 21 patients du groupe A et 23 patients du groupe B ont été évalués cliniquement, radiographiquement et au scanner, cette analyse a été faite rétrospectivement. Dans le groupe A le tunnel a été foré avec une largeur de 8.57 mm et le groupe B de 8.73 mm (8–9 mm). Au suivi, il n’y a pas de différence de taille de tunnel entre ces deux groupes au niveau fémoral, par contre, il existe une différence significative au niveau tibial (p = 0.00192 pour le diamètre coronal et p = 0.0171 pour le diamètre saggital), ces deux groupes sont comparables, cliniquement en ce qui concerne les scores pré et post opératoire de Lysholm et de l’IKDC (p < 0.5 Mann-Whitney U test). La technique du tunnel avec os compacté permet de résister à la tendance à l’élargissement de celui-ci.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, School of Medicine, Yeditepe University, Istanbul, Turkey

    Alper Gokce, Tahsin Beyzadeoglu & Halil Bekler

  2. Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey

    Fatih Ozyer & Fahri Erdogan

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  1. Alper Gokce
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  2. Tahsin Beyzadeoglu
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  3. Fatih Ozyer
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  4. Halil Bekler
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  5. Fahri Erdogan
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Correspondence to Alper Gokce.

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Gokce, A., Beyzadeoglu, T., Ozyer, F. et al. Does bone impaction technique reduce tunnel enlargement in ACL reconstruction?. International Orthopaedics (SICOT) 33, 407–412 (2009). https://doi.org/10.1007/s00264-007-0496-5

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  • DOI: https://doi.org/10.1007/s00264-007-0496-5

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