Dileep Krishnamoorthy Srinivas1, Mahesha Kanthila2, Rama Prakasha Saya3, Jvs Vidyasagar4. 1. Assistant Professor, Deparatment of Orthopaedics, K.S.Hegde Medical Academy , Mangalore, Karnataka, India . 2. Consultant Orthopaedic Surgeon, Mangalore, Karnataka, India . 3. Associate Professor, Department of Medicine, JIPMER , Pondicherry, Pondicherry, India . 4. Consultant, Department of Orthopedic and Arthroscopy, Aware Global Hospitals , Hyderabad, Telangana, India .
Abstract
INTRODUCTION: Bone tunnel enlargement after Anterior Cruciate Ligament Reconstruction (ACL-R) is a well-accepted phenomenon but there are very few published data comparing the extent of tunnel widening by various methods of fixation after ACL-R. AIM: To compare the femoral and tibial tunnel widening following ACL-R with different methods of fixation using CT scan. MATERIALS AND METHODS: This one year prospective study included all patients with chronic Anterior Cruciate Ligament (ACL) injury who underwent primary arthroscopic ACL-R using tripled hamstring tendon autograft. The graft was fixed to the tibial tunnel by Interference Screw (IFS) or Suture Disc (SD) and to the femoral tunnel by IFS, SD, Cross-Pin (CP) or Endo-button CL (Smith & Nephew). The widening of the tibial and femoral tunnels in different methods of fixation was assessed by Computed Tomography (CT) at 12 months follow-up; and was compared using paired sample test. RESULTS: A total of 63 patients were included in the study of which 58 (92%) were males and 5 (8%) were females, with a mean age of 29.1 ± 5.9 years. The tibial tunnel widening at one year follow-up was 1.680 ± 1.08794 (19.37%) and 1.517 ± 0.94834 mm (17.39%) by IFS and SD methods respectively. Femoral tunnel widening at one year follow-up was 1.294 ± 0.231, 1.809 ± 0.912, 1.320 ± 0.238, 1.779 ± 0.889 mm by IFS, SD, EB, and CP methods respectively. Femoral tunnel widening following suture disc method of fixation was very highly significant (p<0.001) in comparison with other methods. CONCLUSION: Femoral tunnel and tibial tunnel widening varies with different methods of fixation and was maximum with suture disc method compared to others at one year follow-up after ACL-R.
INTRODUCTION: Bone tunnel enlargement after Anterior Cruciate Ligament Reconstruction (ACL-R) is a well-accepted phenomenon but there are very few published data comparing the extent of tunnel widening by various methods of fixation after ACL-R. AIM: To compare the femoral and tibial tunnel widening following ACL-R with different methods of fixation using CT scan. MATERIALS AND METHODS: This one year prospective study included all patients with chronic Anterior Cruciate Ligament (ACL) injury who underwent primary arthroscopic ACL-R using tripled hamstring tendon autograft. The graft was fixed to the tibial tunnel by Interference Screw (IFS) or Suture Disc (SD) and to the femoral tunnel by IFS, SD, Cross-Pin (CP) or Endo-button CL (Smith & Nephew). The widening of the tibial and femoral tunnels in different methods of fixation was assessed by Computed Tomography (CT) at 12 months follow-up; and was compared using paired sample test. RESULTS: A total of 63 patients were included in the study of which 58 (92%) were males and 5 (8%) were females, with a mean age of 29.1 ± 5.9 years. The tibial tunnel widening at one year follow-up was 1.680 ± 1.08794 (19.37%) and 1.517 ± 0.94834 mm (17.39%) by IFS and SD methods respectively. Femoral tunnel widening at one year follow-up was 1.294 ± 0.231, 1.809 ± 0.912, 1.320 ± 0.238, 1.779 ± 0.889 mm by IFS, SD, EB, and CP methods respectively. Femoral tunnel widening following suture disc method of fixation was very highly significant (p<0.001) in comparison with other methods. CONCLUSION: Femoral tunnel and tibial tunnel widening varies with different methods of fixation and was maximum with suture disc method compared to others at one year follow-up after ACL-R.
Authors: Alexander E Weber; Demetris Delos; Hanna N Oltean; Katherine Vadasdi; John Cavanaugh; Hollis G Potter; Scott A Rodeo Journal: Am J Sports Med Date: 2015-02-13 Impact factor: 6.202
Authors: Jason B Smoak; Alexander Macfarlane; Melissa A Kluczynski; Michael R Ferrick; Jeremy P Doak; Leslie J Bisson; John M Marzo Journal: Skeletal Radiol Date: 2019-12-17 Impact factor: 2.199