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Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study
Raffaele Iorio1, Antonio Vadalà, Giuseppe Argento
1Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, S. Andrea Hospital, University of Rome La Sapienza, Rome, Italy.
International Orthopaedics
|May 10, 2006
Summary
This study found that arthroscopic anterior cruciate ligament (ACL) reconstruction using quadrupled-hamstring autografts resulted in minimal bone tunnel enlargement. Clinical outcomes improved, with low anterior laxity, suggesting a safe and effective surgical technique.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
- Bone tunnel enlargement after ACL reconstruction can affect graft healing and long-term outcomes.
- Quadrupled-hamstring autografts are increasingly used for ACL reconstruction.
Purpose of the Study:
- To prospectively evaluate bone tunnel size changes after arthroscopic ACL reconstruction with quadrupled-hamstring autograft.
- To correlate tunnel enlargement with clinical outcomes and knee stability.
Main Methods:
- Prospective study of 25 patients undergoing arthroscopic ACL reconstruction with quadrupled-hamstring autograft.
- Preoperative and postoperative clinical assessments (Lysholm score, Tegner activity, IKDC), and KT-1000 arthrometry.
- Computed tomography (CT) scans to measure femoral and tibial tunnel diameters postoperatively and at a mean 10-month follow-up.
Main Results:
- Significant but modest increases in femoral (3%) and tibial (11%) tunnel diameters were observed.
- Postoperative anterior laxity improved, with 70% of patients showing <3 mm difference.
- No significant correlation was found between tunnel enlargement and clinical results or knee stability.
Conclusions:
- The rate of bone tunnel widening in this study was lower than previously reported with other techniques.
- Anatomical surgical technique and a conservative rehabilitation protocol may minimize tunnel enlargement.
- Arthroscopic ACL reconstruction with quadrupled-hamstring autograft demonstrates favorable tunnel healing and clinical outcomes.