2015 ISAKOS Biennial Congress ePoster #1266

The Effect of Femoral Tunnel Widening on One-Year Clinical Outcome After Anteriorcruciate Ligament Reconstruction

Remi Philippot, MD, PhD, Prof, Saint Priest en Jarez FRANCE
Benjamin Basson, MD, Saint Etienne FRANCE
Frederic Farizon, St Etienne Cedex 2 FRANCE
chu saint etienne, saint etienne, loire, FRANCE

FDA Status Not Applicable

Summary: The femoral tunnel widening after ACL reconstruction have a significant effect on the clinical outcomes.

Abstract:

Introduction

The effect of femoral tunnel widening on clinical results after anterior cruciateligament reconstruction has been rarely investigated. In our study, ACL reconstructions were performed using semitendinosus and gracilis (STG) tendon grafts and single cortical fixation on the femoral side. The aim was to analyse femoral tunnel widening at one-year and evaluate the effect of femoral tunnel widening on clinical and laximetric outcome. Material and methods : 46 patients of mean age 24 years [13 - 43 years] were enrolled in this prospective continuous single operator monocenter study. Clinical protocol included preoperative and one-year evaluation with subjective and objective IKDC clinical scores. Knee laxity was measured using the GNRB arthrometer. CT scan was used for radiographic examination at one year follow-up. The amount of femoral tunnel widening was measured by means of the 3D image processing OsiriX software. The cross-sectional area of each tunnel was measured at four different locations from the cortex named F1 to the joint named F4. Results : The subjective IKDC score improved from a preoperative score of 50 to a one-year postoperative score of 81.8. The side-to-side difference in knee laxity evolved from 2.94 mm to 0.74 mm. The objective IKDC score at last follow-up was rated A in 27 patients and B in 17. CT scan data revealed a mean cone shape widening of the femoral tunnel of 49.32% : F1 cross-sectional area was 68.52 mm2 ± 23.85 ; F2 cross-sectional area was 92.46 mm2 ± 29.51 ;F3 cross-sectional area was 107.15 mm2 ± 30.88 and F4 cross-sectional area was 111.6 mm2 ± 30.48. Femoral tunnel widening at the level of the joint (F4) was negatively correlated (- 0.3) with the IKDC subjective score (p=0.05) at one year.Conclusion : This study revealed a significant widening of the femoral tunnel by demonstrating its conical shape at one-postoperative year. There was no relationship between femoral tunnel widening and residual knee laxity but a significant correlation could be established between femoral tunnel widening close to the joint and IKDC scores.