Evaluation of tibial bone-tunnel changes with X-ray and computed tomography after ACL reconstruction using a bone-patella tendon-bone autograft.

Thirteen patients who underwent anterior cruciate ligament (ACL) reconstruction with bone-patella tendon-bone autografts (BTB) using interference screws were the subjects of this study. We analysed the relationship between bone-tunnel changes and clinical results 2 years after ACL reconstruction. To investigate changes, X-ray images were used to evaluate bone-tunnel enlargement, and computed tomography (CT) was used to evaluate the sclerotic area around the bone tunnel. The KT-2000 was used to measure the discrepancy of tibial anterior displacement between the affected and nonaffected sides (DTAD). There was no correlation between bone-tunnel enlargement and DTAD. On the other hand, in the CT evaluation, there was a significant correlation between the sclerotic area and DTAD. Our results suggest that it is more significant to analyse the area of sclerotic change than bone-tunnel enlargement for clinical evaluation. We cannot evaluate bone-tunnel changes correctly with two-dimensional X-rays and cannot analyse the sclerotic area using X-rays. Therefore, we recommend that CT, with which it is possible to analyse the sclerotic area, be used to evaluate bone-tunnel changes and clinical results.