Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior
Silvampatti Ramasamy Sundararajan1, Balaji Sambandam1, Ajay Singh1
1Department of Arthroscopy and Sports Medicine, Ganga Medical Centre & Hospital, Coimbatore, India.
Purpose:
Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening.
Materials And Methods:
Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up.
Results:
The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups.
Conclusions:
The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices.
Level Of Evidence:
Level 3, Retrospective Cohort.
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