Yuta Tachibana1, Tatsuo Mae2, Konsei Shino3, Takashi Kanamoto1, Kazuomi Sugamoto4, Hideki Yoshikawa1, Ken Nakata1. 1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan. 2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan. ta-mae@umin.ac.jp. 3. Sports Orthopaedic Surgery Center, Yukioka Hospital, 2-2-3 Ukita, Kita-ku, Osaka, Osaka, 530-0021, Japan. 4. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
Abstract
PURPOSE: Few studies investigated the enlargement inside the tunnel as well as the morphological change at the aperture after anterior cruciate ligament (ACL) reconstruction, whereas the tunnel enlargement has been well documented. The purposes were to evaluate the change in the cross-sectional area along the femoral tunnel and to morphologically clarify the enlargement at the femoral tunnel aperture after anatomic triple-bundle (ATB) ACL reconstruction. METHODS: The study included 15 patients with unilateral ACL rupture. ATB ACL reconstruction was performed using semitendinosus tendon autografts. Three-dimensional computer models of the femur and bone tunnels were reconstructed from computed tomography images obtained 3 weeks and 1 year postoperatively. The cross-sectional area at the aperture as well as inside the tunnel was compared between the two periods. Likewise, the location of tunnel walls and center in the tunnel footprint were evaluated. RESULTS: The cross-sectional area enlarged by 22.7 % for anteromedial/intermediate graft (P = 0.002) and 28.6 % for posterolateral graft (P = 0.002) at the aperture, while decreased by 36.2 % at 10 mm from the aperture for anteromedial/intermediate graft (P = 0.004). Both the anterior and posterior walls shifted anteriorly, while the distal wall shifted distally in both tunnels. Consequently, the center in the footprint significantly shifted anteriorly (4.9-6.6 %) and distally (2.2-2.6 %) in both tunnels. CONCLUSIONS: The femoral tunnel enlargement occurred at the aperture after ATB ACL reconstruction, but did not occur in the middle of the femoral tunnel. The morphology at the aperture changed with time after surgery as the tunnel walls translated anteriorly and distally. LEVEL OF EVIDENCE: Case series, Level IV.
PURPOSE: Few studies investigated the enlargement inside the tunnel as well as the morphological change at the aperture after anterior cruciate ligament (ACL) reconstruction, whereas the tunnel enlargement has been well documented. The purposes were to evaluate the change in the cross-sectional area along the femoral tunnel and to morphologically clarify the enlargement at the femoral tunnel aperture after anatomic triple-bundle (ATB) ACL reconstruction. METHODS: The study included 15 patients with unilateral ACL rupture. ATB ACL reconstruction was performed using semitendinosus tendon autografts. Three-dimensional computer models of the femur and bone tunnels were reconstructed from computed tomography images obtained 3 weeks and 1 year postoperatively. The cross-sectional area at the aperture as well as inside the tunnel was compared between the two periods. Likewise, the location of tunnel walls and center in the tunnel footprint were evaluated. RESULTS: The cross-sectional area enlarged by 22.7 % for anteromedial/intermediate graft (P = 0.002) and 28.6 % for posterolateral graft (P = 0.002) at the aperture, while decreased by 36.2 % at 10 mm from the aperture for anteromedial/intermediate graft (P = 0.004). Both the anterior and posterior walls shifted anteriorly, while the distal wall shifted distally in both tunnels. Consequently, the center in the footprint significantly shifted anteriorly (4.9-6.6 %) and distally (2.2-2.6 %) in both tunnels. CONCLUSIONS: The femoral tunnel enlargement occurred at the aperture after ATB ACL reconstruction, but did not occur in the middle of the femoral tunnel. The morphology at the aperture changed with time after surgery as the tunnel walls translated anteriorly and distally. LEVEL OF EVIDENCE: Case series, Level IV.
Authors: Yuki Kato; Sheila J M Ingham; Akira Maeyama; Pisit Lertwanich; Joon Ho Wang; Yutaka Mifune; Scott Kramer; Patrick Smolinski; Freddie H Fu Journal: Arthroscopy Date: 2011-10-21 Impact factor: 4.772
Authors: Jae Gyoon Kim; Min Ho Chang; Hong Chul Lim; Ji Hoon Bae; Jin Hwan Ahn; Joon Ho Wang Journal: Am J Sports Med Date: 2013-08-27 Impact factor: 6.202