Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons
- PMID: 11522075
- DOI: 10.1007/s001670100201
Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons
Abstract
We retrospectively reviewed 87 anterior cruciate ligament reconstructions using autogenous hamstring tendons with the Endobutton technique to investigate the relationship between bone tunnel enlargement and clinical outcome and to identify factors that contribute to the enlargement. The clinical outcome was evaluated using the Lysholm score and KT-1000 arthrometer. The location of the femoral tunnel with respect to Blumensaat's line, the tibial tunnel with respect to the tibial plateau, and the angle between the femoral tunnel and Blumensaat's line (femoral tunnel angle) were measured. Bone tunnel enlargement was observed in 32 patients (37%). Enlargement occurred in 22 of the femoral tunnels and 26 of the tibial tunnels. Enlargement of both tunnels occurred in 16 knees. There was no statistical difference in Lysholm scores or KT-1000 arthrometer measurements between the enlarged group and the unenlarged group. The femoral tunnel was placed more anteriorly in the enlarged femoral tunnel group than in the unenlarged femoral tunnel group. The tibial tunnel was placed more anteriorly in the enlarged tibial tunnel group than in the unenlarged tibial tunnel group. The femoral tunnel angle was significantly smaller in the enlarged femoral tunnel group than in the femoral unenlarged group. Gender, patient age, intraoperative isometricity, and graft size were not significant factors. Bone tunnel enlargement was not correlated with the clinical outcome measures. We conclude that the main factor associated with tunnel enlargement are the locations and angles of the tunnels. The windshield-wiper motion of the graft may be enhanced by changing tension in the graft due to tunnel malposition. An acute femoral tunnel angle may increase the mechanical stress on the anterior margin of the femoral tunnel.
Similar articles
-
Bone tunnel enlargement following anterior cruciate ligament reconstruction: a randomised comparison of hamstring and patellar tendon grafts with 2-year follow-up.Knee Surg Sports Traumatol Arthrosc. 2001;9(2):86-91. doi: 10.1007/s001670100191. Knee Surg Sports Traumatol Arthrosc. 2001. PMID: 11354858 Clinical Trial.
-
A retrospective review of bone tunnel enlargement after anterior cruciate ligament reconstruction with hamstring tendons fixed with a metal round cannulated interference screw in the femur.Arthroscopy. 2006 Oct;22(10):1093-9. doi: 10.1016/j.arthro.2006.05.017. Arthroscopy. 2006. PMID: 17027407
-
Bone tunnel enlargement after anterior cruciate ligament reconstruction with semitendinosus tendon using Endobutton fixation on the femoral side.Arthroscopy. 1998 Nov-Dec;14(8):810-5. doi: 10.1016/s0749-8063(98)70015-5. Arthroscopy. 1998. PMID: 9848590
-
Anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons, bone patellar tendon, or quadriceps tendon-graft with press-fit fixation without hardware. A new and innovative procedure.Orthop Clin North Am. 2003 Jan;34(1):49-64. doi: 10.1016/s0030-5898(02)00070-6. Orthop Clin North Am. 2003. PMID: 12735201 Review.
-
Tunnel enlargement after anterior cruciate ligament surgery.Am J Sports Med. 2004 Mar;32(2):543-9. doi: 10.1177/0363546504263151. Am J Sports Med. 2004. PMID: 14977688 Review.
Cited by
-
Tunnel enlargement 5 years after anterior cruciate ligament reconstruction: a radiographic and functional evaluation.Eur J Orthop Surg Traumatol. 2014 Feb;24(2):217-23. doi: 10.1007/s00590-013-1175-4. Epub 2013 Feb 12. Eur J Orthop Surg Traumatol. 2014. PMID: 23412316
-
Eccentrically widened bone tunnels after all-inside anterior cruciate ligament reconstruction: a computed tomography and three-dimensional model-based analysis.Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2374-2385. doi: 10.1007/s00167-022-07164-3. Epub 2022 Sep 22. Knee Surg Sports Traumatol Arthrosc. 2023. PMID: 36138208 Free PMC article.
-
Femoral tunnel widening is similar between anteromedial portal and transtibial techniques following single-bundle anterior cruciate ligament reconstruction: a systematic review and meta-analysis.Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):626-635. doi: 10.1007/s00167-018-5204-z. Epub 2018 Oct 10. Knee Surg Sports Traumatol Arthrosc. 2019. PMID: 30306239
-
Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft.J Exp Orthop. 2017 Sep 15;4(1):30. doi: 10.1186/s40634-017-0104-6. J Exp Orthop. 2017. PMID: 28916912 Free PMC article.
-
Biomechanical evaluation of the quadriceps tendon autograft for anterior cruciate ligament reconstruction: a cadaveric study.Am J Sports Med. 2014 Mar;42(3):723-30. doi: 10.1177/0363546513516603. Epub 2014 Jan 8. Am J Sports Med. 2014. PMID: 24401682 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical