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

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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.

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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Authors and Affiliations

  1. Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy

    Raffaele Iorio, Antonio Vadalà, Vincenzo Di Sanzo & Andrea Ferretti

  2. Radiology Unit, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy

    Giuseppe Argento

  3. Via Grottarossa 1065, Roma, Italy

    Andrea Ferretti

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  1. Raffaele Iorio
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  2. Antonio Vadalà
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  3. Giuseppe Argento
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  4. Vincenzo Di Sanzo
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  5. Andrea Ferretti
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Correspondence to Andrea Ferretti.

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Iorio, R., Vadalà, A., Argento, G. et al. Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study. International Orthopaedics (SICO 31, 49–55 (2007). https://doi.org/10.1007/s00264-006-0118-7

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  • DOI: https://doi.org/10.1007/s00264-006-0118-7

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