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Early integration of a bone plug in the femoral tunnel in rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: a prospective computed tomography analysis

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

Abstract

Purpose

The purpose of this prospective study was to evaluate how early the bone plug was integrated into the rectangular femoral tunnel after anatomical ACL reconstruction using a bone-patellar tendon-bone (BTB) graft via a rectangular tunnel (RT BTB ACL-R).

Methods

Twenty consecutive patients who had undergone the reconstruction procedure were evaluated by CT scans at 4 and 8 weeks postoperatively. In each scan, 30 slices for multiplanar reconstruction were collected parallel to the long axis of the parallelepiped femoral tunnel and perpendicular to the tendinous plane of the bone plug. Each slice was classified as “complete,” indicating no visible gap between the plug and the tunnel wall or trabecular continuity or “incomplete,” showing a visible gap. Bone plug-tunnel integration was evaluated as “excellent,” “good,” “fair,” or “poor” for >20, 11–20, 5–10, and <4 “complete” slices, respectively.

Results

In this evaluation, 55% of the patients were rated as “excellent” on the first scan, and 80% were “excellent” on the second scan, showing healing over time. The CT values at the anterior interface between the bone plug and the tunnel wall were also measured on both scans. The mean changes in CT value at 8 weeks were significantly lower than those at 4 weeks.

Conclusion

This study shows that bone plug-femoral tunnel integration was almost complete by 8 weeks after surgery using RT BTB ACL-R.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedics, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8456, Japan

    Tomoyuki Suzuki, Hidenori Otsubo & Toshihiko Yamashita

  2. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino, Osaka, 583-8555, Japan

    Konsei Shino

  3. Department of Sports Orthopaedics, Yukioka Hospital, 2-2-3 Ukita, Kita-ku, Osaka, Osaka, 530-0021, Japan

    Shigeto Nakagawa

  4. Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan

    Ken Nakata, Takehiko Iwahashi & Kazutaka Kinugasa

Authors
  1. Tomoyuki Suzuki
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  2. Konsei Shino
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  3. Shigeto Nakagawa
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  4. Ken Nakata
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  5. Takehiko Iwahashi
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  7. Hidenori Otsubo
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  8. Toshihiko Yamashita
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Correspondence to Tomoyuki Suzuki.

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Suzuki, T., Shino, K., Nakagawa, S. et al. Early integration of a bone plug in the femoral tunnel in rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: a prospective computed tomography analysis. Knee Surg Sports Traumatol Arthrosc 19 (Suppl 1), 29–35 (2011). https://doi.org/10.1007/s00167-011-1481-5

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  • DOI: https://doi.org/10.1007/s00167-011-1481-5

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