Raul Mayr1, Vinzenz Smekal2, Christian Koidl1, Christian Coppola1, Josef Fritz3, Ansgar Rudisch4, Christof Kranewitter4, René Attal5. 1. Department of Trauma Surgery, Medical University of Innsbruck, Austria. 2. AUVA Trauma Center Klagenfurt, Klagenfurt, Austria. 3. Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria. 4. Department of Radiology, Medical University of Innsbruck, Austria. 5. Department of Trauma Surgery, Medical University of Innsbruck, Austria. Electronic address: rene.attal@tirol-kliniken.at.
Abstract
BACKGROUND:Tunnel widening after anterior cruciate ligament reconstruction (ACLR) is influenced by the surgical and fixation techniques used. Computed tomography (CT) is the most accurate image modality for assessing tunnel widening, but magnetic resonance imaging (MRI) might also be reliable for tunnel volume measurements. In the present study tunnel widening after ACLR using biodegradable interference screw fixation was compared with all-inside ACLR using button fixation, with tunnel volume changes being measured on CT and MRI scans. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS:Thirty-three patients were randomly assigned to hamstring ACLR using a biodegradable interference screw or all-inside cortical button fixation. CT and MRI scanning were done at the time of surgery and six months after. Tunnel volume changes were calculated and compared. RESULTS: On CT, femoral tunnel volumes changed from the postoperative state (100%) to 119.8% with screw fixation and 143.2% with button fixation (P=0.023). The changes in tibial tunnel volumes were not significant (113.9% vs. 117.7%). The changes in bone tunnel volume measured on MRI were comparable with those on CT only for tunnels with interference screws. Tibial tunnels with button fixation were significantly underestimated on MRI scanning (P=0.018). CONCLUSIONS: All-inside ACLR using cortical button fixation results in increased femoral tunnel widening in comparison with ACLR with biodegradable interference screw fixation. MRI represents a reliable imaging modality for future studies investigating tunnel widening with interference screw fixation.
RCT Entities:
BACKGROUND: Tunnel widening after anterior cruciate ligament reconstruction (ACLR) is influenced by the surgical and fixation techniques used. Computed tomography (CT) is the most accurate image modality for assessing tunnel widening, but magnetic resonance imaging (MRI) might also be reliable for tunnel volume measurements. In the present study tunnel widening after ACLR using biodegradable interference screw fixation was compared with all-inside ACLR using button fixation, with tunnel volume changes being measured on CT and MRI scans. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: Thirty-three patients were randomly assigned to hamstring ACLR using a biodegradable interference screw or all-inside cortical button fixation. CT and MRI scanning were done at the time of surgery and six months after. Tunnel volume changes were calculated and compared. RESULTS: On CT, femoral tunnel volumes changed from the postoperative state (100%) to 119.8% with screw fixation and 143.2% with button fixation (P=0.023). The changes in tibial tunnel volumes were not significant (113.9% vs. 117.7%). The changes in bone tunnel volume measured on MRI were comparable with those on CT only for tunnels with interference screws. Tibial tunnels with button fixation were significantly underestimated on MRI scanning (P=0.018). CONCLUSIONS: All-inside ACLR using cortical button fixation results in increased femoral tunnel widening in comparison with ACLR with biodegradable interference screw fixation. MRI represents a reliable imaging modality for future studies investigating tunnel widening with interference screw fixation.
Authors: Sven Putnis; Thomas Neri; Samuel Grasso; James Linklater; Brett Fritsch; David Parker Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-06-17 Impact factor: 4.342
Authors: Alexandre Biset; Adil Douiri; James R Robinson; Pierre Laboudie; Philippe Colombet; Nicolas Graveleau; Nicolas Bouguennec Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-07-25 Impact factor: 4.114