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. 2023 Dec 30:48:102331.
doi: 10.1016/j.jcot.2023.102331. eCollection 2024 Jan.

Decreased femur tunnel widening after augmented suspensory fixation compared to suspensory fixation for single bundle hamstring ACL reconstruction

Sam James Daniel  1 , Jozy Timothy  1 , Madhavi Kandagaddala  2 , K Reka  3 , Pradeep Mathew Poonnoose  1 , Anil Thomas Oommen  1
Affiliations

Decreased femur tunnel widening after augmented suspensory fixation compared to suspensory fixation for single bundle hamstring ACL reconstruction

Sam James Daniel et al. J Clin Orthop Trauma. .

Erratum in

Abstract

Background: Tunnel widening after Anterior cruciate ligament (ACL) reconstruction using a hamstring graft is known to occur at follow-up. Our study aimed to investigate the effect of suspensory fixation augmentation using an interference screw on tunnel widening in single-bundle hamstring ACL reconstruction.

Methods: 48 patients who had single bundle ACL reconstruction with femoral fixed loop fixation technique in 15 knees, and, fixed loop with augmented aperture (bio screw) fixation in 33 knees were analyzed. The width of the tunnel was measured using radiographs immediate post-op and at follow-up within 1 year. Computerized Tomogram (CT) measurements of the tunnels and functional scores were also done with overall follow-up for the fixed loop group being 21.33 months (Standard Deviation (SD)11.14) and the Augmentation group 9.12 months (SD 3.83).

Results: Midpoint femur tunnel widening was reduced in the augmentation group, with measurements of 0.74 (SD 1.05) mm Antero Posterior (AP) and 1.01 (SD 1.04) mm in the Lateral view, compared to 1.54 (SD 1.48) mm AP and 1.79 (SD1.47 mm) in the Lateral for the fixed button group. The radiological widening was considerably less in the augmentation group with a p-value of 0.07. AP aperture widening in the augmentation group was 1.25(SD 1.10 mm), and 1.09(SD0.98) mm in the lateral view. The fixed button-only group measured 1.53 (SD1.30) mm in the AP, and 1.65 (SD 1.29) mm in the lateral view, both of which were not statistically significant. The follow-up Lysholm and International Knee Documentation Committee (IKDC) scores were similar for the 2 groups.

Conclusion: Femoral tunnel midpoint and aperture widening were reduced with the fixed loop with aperture (bio screw) augmentation technique for hamstring grafts in single bundle ACL fixation within 1 year with comparable functional scores.

Level of evidence: 4.

Keywords: ACL; Arthroscopy; Femur endo button with screw; Knee; Single bundle hamstring; Tunnel width.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Antero Posterior radiograph at review with Femur and Tibia Tunnel Measurements.
Fig. 2
Fig. 2
Lateral radiograph at review with Femur and Tibia Tunnel Measurements.
Fig. 3
Fig. 3
Distal Femur CT at review with Femur Tunnel Measurements.
Fig. 4
Fig. 4
Distal Femur axial CT at review with Femur Tunnel Measurements.
Fig. 5
Fig. 5
Proximal Tibia AnteroPosterior CT at review with Tibia Tunnel Measurements.
Fig. 6
Fig. 6
Proximal Tibia Axial CT at review with Tibia Tunnel Measurements.
See this image and copyright information in PMC

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