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Tibial tunnel widening after hamstring anterior cruciate ligament reconstructions: comparison between Rigidfix and
Nam-Hong Choi1, Soon-Young Yoo, Brian N Victoroff
1Department of Orthopaedic Surgery, Eulji Medical Center, 280-1, Hagye-1-dong, Nowon-gu, Seoul, 139-231, Republic of Korea. cnh2406@yahoo.com
Background:
There is no study comparing tibial tunnel widening after hamstring anterior cruciate ligament (ACL) reconstructions between RigidFix(r) and Bio-TransFix(r).
Methods:
Hamstring ACL reconstructions using RigidFix(r) in 56 patients and Bio-TransFix(r) in 41 with a minimum of 2years postoperative evaluation were reviewed. Tibial fixation was performed using Intrafix in both groups. On the anterior-posterior (AP) and lateral radiographs, the diameter of the tibial tunnel was measured at proximal, middle, and distal positions. Postoperative laxity evaluations were performed using Lachman test, pivot-shift test, and instrumented laxity testing using the KT-1000 arthrometer.
Results:
On the AP and lateral radiographs, the average diameter of the tibial tunnel in the Bio-TransFix(r) group significantly increased after 6months compared to the immediate postoperative measurement (p=0.002 and p=0.002, respectively). However, the average diameter of the tibial tunnel in the RigidFix(r) group did not increase after 6months compared to the immediate postoperative measurement. Tunnel widening at 12months postoperatively in the Bio-TransFix(r) group was significantly more than that of the RigidFix(r) group on AP and lateral radiographs (p=0.012 and 0.016, respectively). Tunnel widening at 24months postoperatively showed a significant difference between the two groups (p=0.000 and 0.000, respectively). Fifteen patients (36.6%) in the Bio-TransFix(r) group and 15 patients (26.8%) in the RigidFix(r) group showed tunnel widening. There were no significant differences in results of the Lachman and pivot-shift tests, and mean KT-1000 measurement between the two groups.
Conclusion:
The Bio-TransFix(r) group showed progressive tibial tunnel widening after 6months postoperatively but no clinical signs of instability.
Level Of Evidence:
Level III.