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Bone Tunnel Changes After ACL Reconstruction

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ACL Injury and Its Treatment

Abstract

Femoral and tibial bone tunnel enlargement has been reported after anterior cruciate ligament (ACL) reconstruction. Although the exact etiology of bone tunnel enlargement after ACL reconstruction remains unknown, a complex interplay between mechanical and biological factors has been proposed to explain this phenomenon. The mechanical factors include motion of the graft within the bone tunnel, fixation methods or devices, stress shielding of the graft, improper graft placement, and rehabilitation protocols. The biological factors include the infiltration of inflammatory cytokines or synovial fluid into the bone tunnel, the use of allograft tissue, and the bioabsorbable fixation device. These factors are thought to induce osteolysis and bone tunnel enlargement after ACL reconstruction. Several studies reported that bone tunnel enlargement did not affect the clinical results; however, enlarged bone tunnel often complicates revision ACL reconstruction. This chapter describes the multiple causes of bone tunnel enlargement after ACL reconstruction. Future research and improvement of surgical technique are aimed at prevention of bone tunnel enlargement.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Daisuke Araki M.D., Ph.D., Takehiko Matsushita & Ryosuke Kuroda

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  1. Daisuke Araki M.D., Ph.D.
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  2. Takehiko Matsushita
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  3. Ryosuke Kuroda
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Correspondence to Daisuke Araki M.D., Ph.D. .

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Editors and Affiliations

  1. Hiroshima University, Hiroshima, Hiroshima, Japan

    Mitsuo Ochi

  2. Sports Orthopaedic Center, Yukioka Hospital, Osaka, Osaka, Japan

    Konsei Shino

  3. Graduate School of Medicine, Hokkaido University , Sapporo, Japan

    Kazunori Yasuda

  4. Graduate School of Medicine, Kobe University, Kobe, Japan

    Masahiro Kurosaka

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Araki, D., Matsushita, T., Kuroda, R. (2016). Bone Tunnel Changes After ACL Reconstruction. In: Ochi, M., Shino, K., Yasuda, K., Kurosaka, M. (eds) ACL Injury and Its Treatment. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55858-3_21

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