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Less tunnel enlargement in anatomical triple bundle anterior cruciate ligament reconstruction than in double bundle anterior cruciate ligament reconstruction in randomized clinical trial

Less tunnel enlargement in anatomical triple bundle anterior cruciate ligament reconstruction than in double bundle anterior cruciate ligament reconstruction in randomized clinical trial

Kousuke Shiwaku, MD, JAPAN Tomoaki Kamiya, MD, JAPAN Tomoyuki Suzuki, MD, PhD, JAPAN Takashi Matsumura, MD, JAPAN Atsushi Teramoto, MD, PhD, JAPAN

Sapporo Medical University, Sapporo, Hokkaido, JAPAN


2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

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Summary: Less tunnel enlargement in anatomical triple bundle anterior cruciate ligament reconstruction than in double bundle anterior cruciate ligament reconstruction in randomized clinical trial


Introduction

There were no study comparing the tunnel enlargement of double bundle anterior cruciate ligament reconstruction (DB-ACLR) and triple bundle anterior cruciate ligament reconstruction (TB-ACLR). The primary purpose of this study was to compare the tibial tunnel enlargement of DB-ACLR and TB-ACLR in a prospective randomized clinical trial. The secondary purpose of this study was to compare the rate of tibial tunnel coalition of DB-ACLR and TB-ACLR. Our hypothesis was that tibial tunnel enlargement of TB-ACLR was less than DB-ACLR and the rate of tunnel coalition was equal.

Methods

In a randomized clinical trial, 25 patients were followed up and underwent computed tomography (CT) 2 weeks and 1 year after surgery and included in this study. Eleven patients underwent double bundle anterior cruciate ligament reconstruction and 14 patients underwent triple bundle anterior cruciate ligament reconstruction. Assessment of tunnel positions and tunnel coalition at the tibial tunnel aperture using three-dimensional CT. Also, tunnel enlargement rate as calculated by measuring the sagittal and axial widths of the tibial bone tunnel at 10 mm from tibial tunnel aperture. These parameters were compared between the two groups

Results

There were no significant differences in changes of the tunnel positions and tunnel coalitions between the two groups. In the sagittal view, the tunnel enlargement rates of the AMM and AML of TB-ACLR group were significantly smaller than AM of DB-ACLR group (p = .01 and <.01), while there was no significant difference between the PL tunnel enlargement of the two groups. Similarly, in the axial view, the tunnel enlargement raties of the AMM and AML of TB-ACLR group were significantly smaller than AM of DB-ACLR group (p = .01 and <.01), while there was no significant difference between the PL tunnel enlargement of the two groups.

Conclusion

This randomized clinical trial showed that there were less tunnel widening in the AMM and AML tibial tunnel of TB-ACLR groups than AM tibial tunnel of DB-ACLR groups. The possible reason may be the biomechanical advantages of TB-ACLR. Additionally, there were no significant differences of the rates of having any coalition between DB-ACLR and TB-ACLR groups.


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