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. 2016 Nov;10(11):RC09-RC11.
doi: 10.7860/JCDR/2016/22660.8907. Epub 2016 Nov 1.

Femoral and Tibial Tunnel Widening following Anterior Cruciate Ligament Reconstruction using Various Modalities of Fixation: A Prospective Observational Study

Dileep Krishnamoorthy Srinivas  1 , Mahesha Kanthila  2 , Rama Prakasha Saya  3 , Jvs Vidyasagar  4
Affiliations

Femoral and Tibial Tunnel Widening following Anterior Cruciate Ligament Reconstruction using Various Modalities of Fixation: A Prospective Observational Study

Dileep Krishnamoorthy Srinivas et al. J Clin Diagn Res. 2016 Nov.

Abstract

Introduction: Bone tunnel enlargement after Anterior Cruciate Ligament Reconstruction (ACL-R) is a well-accepted phenomenon but there are very few published data comparing the extent of tunnel widening by various methods of fixation after ACL-R.

Aim: To compare the femoral and tibial tunnel widening following ACL-R with different methods of fixation using CT scan.

Materials and methods: This one year prospective study included all patients with chronic Anterior Cruciate Ligament (ACL) injury who underwent primary arthroscopic ACL-R using tripled hamstring tendon autograft. The graft was fixed to the tibial tunnel by Interference Screw (IFS) or Suture Disc (SD) and to the femoral tunnel by IFS, SD, Cross-Pin (CP) or Endo-button CL (Smith & Nephew). The widening of the tibial and femoral tunnels in different methods of fixation was assessed by Computed Tomography (CT) at 12 months follow-up; and was compared using paired sample test.

Results: A total of 63 patients were included in the study of which 58 (92%) were males and 5 (8%) were females, with a mean age of 29.1 ± 5.9 years. The tibial tunnel widening at one year follow-up was 1.680 ± 1.08794 (19.37%) and 1.517 ± 0.94834 mm (17.39%) by IFS and SD methods respectively. Femoral tunnel widening at one year follow-up was 1.294 ± 0.231, 1.809 ± 0.912, 1.320 ± 0.238, 1.779 ± 0.889 mm by IFS, SD, EB, and CP methods respectively. Femoral tunnel widening following suture disc method of fixation was very highly significant (p<0.001) in comparison with other methods.

Conclusion: Femoral tunnel and tibial tunnel widening varies with different methods of fixation and was maximum with suture disc method compared to others at one year follow-up after ACL-R.

Keywords: Computed tomography; Femoral tunnel; Graft.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
CT scan measurement of tibial tunnel.
[Table/Fig-2]:
[Table/Fig-2]:
CT scan measurement of femoral tunnel.
[Table/Fig-3]:
[Table/Fig-3]:
Fixation method.
[Table/Fig-4]:
[Table/Fig-4]:
Tibial tunnel widening at one year.
[Table/Fig-6]:
[Table/Fig-6]:
Femoral tunnel widening at one year.
See this image and copyright information in PMC

References

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