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Patient age as a preoperative factor associated with tunnel enlargement following double-bundle anterior cruciate ligament reconstruction using hamstring tendon autografts

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

A few studies have detected associations of post-operative tunnel enlargement with sex, age, and the timing of anterior cruciate ligament reconstruction (ACLR). The aim of the present study was to investigate the correlation between post-operative tunnel enlargement following ACLR using hamstring tendon autografts and preoperative factors. The authors hypothesized that tunnel enlargement is associated with age in patients undergoing ACLR.

Methods

One hundred and six patients (male, n = 57; female, n = 49; mean age, 26.9 years) who underwent double-bundle ACL reconstruction were included in the present study. The time between injury and surgery was 26.3 ± 71.4 weeks. Computed tomographic scans of the operated knee were obtained at 2 weeks and 6 months after surgery. The area of the tunnel aperture was measured for the femoral anteromedial tunnel (FAMT), femoral posterolateral tunnel (FPLT), tibial anteromedial tunnel (TAMT), and tibial posterolateral tunnel. The percentage of tunnel area enlargement was defined as the area at 2 weeks after ACLR subtracted from the area at 6 months after ACLR and then divided by the area at 2 weeks after ACLR. Spearman’s correlation coefficient was calculated for each factor. The patients were divided into two groups based on age. Patients aged <40 and ≥40 years were assigned to Groups A and B, respectively. The differences in the outcomes and characteristics of the two groups were evaluated.

Results

The percentage of enlargement of the FAMT, FPLT, and TAMT was correlated with patient age (r = 0.31, p = 0.001; r = 0.24, p = 0.012; and r = 0.30, p = 0.002, respectively). In total, 87 and 19 knees were classified into Groups A and B, respectively, based on patient age. The percentage of enlargement of the FAMT was significantly higher in Group B than A (78 vs. 60%, respectively; p = 0.01). The percentage of enlargement of the TAMT was significantly higher in Group B than A (53 vs. 36%, respectively; p = 0.03).

Conclusion

The percentage of enlargement of the FAMT and TAMT was associated with patient age. These findings suggest the need to consider the possibility of tunnel enlargement when double-bundle ACLR is performed for patients aged >40 years. Age was a preoperative factor associated with tunnel enlargement.

Level of evidence

III.

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Authors and Affiliations

  1. Zensyukai Hospital Gunma Sports Medicine Research Center, 54-1 Utsuboi-machi, Maebashi, Gunma, 379-2115, Japan

    Shinya Yanagisawa, Masashi Kimura, Keiichi Hagiwara, Atsuko Ogoshi, Tomoyuki Nakagawa & Hiroyuki Shiozawa

  2. Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, Japan

    Takashi Ohsawa

Authors
  1. Shinya Yanagisawa
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  2. Masashi Kimura
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  3. Keiichi Hagiwara
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  4. Atsuko Ogoshi
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  5. Tomoyuki Nakagawa
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  6. Hiroyuki Shiozawa
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  7. Takashi Ohsawa
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Correspondence to Shinya Yanagisawa.

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The authors declare no conflict of interest in association with the present study.

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No external source of funding was used.

Ethical approval

Institutional review board approval for the study was provided by Zensyukai Hospital (No. 28060801).

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Informed consent has been obtained by all study objects.

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Yanagisawa, S., Kimura, M., Hagiwara, K. et al. Patient age as a preoperative factor associated with tunnel enlargement following double-bundle anterior cruciate ligament reconstruction using hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc 26, 1230–1236 (2018). https://doi.org/10.1007/s00167-017-4611-x

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  • DOI: https://doi.org/10.1007/s00167-017-4611-x

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