2015 ISAKOS Biennial Congress ePoster #1385
Precise Evaluation of the Bone Tunnel Widening After Anatomical Single Bundle Anterior Cruciate Ligament Reconstruction
Toshiaki Kameda, MD, Sapporo, Hokkaido JAPAN
Masayuki Inoue, MD, PhD, Sapporo, Hokkaido JAPAN
Takuro Sasaki, MD,, Sapporo, Hokkaido JAPAN
Tomoya Matsuhashi, MD, Sapporo, Hokkaido JAPAN
Daisuke Kawahara, RPT, Sapporo, Hokkaido JAPAN
Norimasa Iwasaki, MD, PhD, Sapporo, Hokkaido JAPAN
Kazunori Yasuda, MD, PhD, Prof., Sapporo, Hokkaido JAPAN
NTT-EAST Sapporo Hospital, Sapporo, Hokkaido, JAPAN
FDA Status Not Applicable
Summary: We evaluated the effect of remnant preservation on the bone tunnel widening after anatomical single bundle ACL reconstruction precisely using CT. In this study, remnant preservation did not affect the bone tunnel widening, the type of shape and clinical outcomes. The effect of remnant preservation for anatomical double bundle ACL reconstruction should be needed to clarify in future.
Abstract:
There are several studies for the bone tunnel widening after anterior cruciate ligament (ACL). However, there are a few reports that examined relationship between remnant preservation and the bone tunnel widening after anatomical single bundle ACL reconstruction using X-ray. Farther more there is no study using CT. In this current study, we evaluated the effect of remnant preservation on the bone tunnel widening to perform a more detailed evaluation using Multiplanar reconstructed CT (MPR-CT).
Materials And Methods
40 patients (18 male and 22 female patients) who underwent anatomical single bundle ACL reconstruction with hamstring tendon autograft were enrolled in this study. The mean age at surgery was 30.1 years old (range, 14 to 58 years old). Averaged femoral side diameter of the graft was 7.9mm, and tibial side diameter was 8.2mm. Averaged fixed tension of the graft was 28.9N. Using MPR-CT, we measured the diameter of the bone tunnel outlet on the femur side and the tibial side in orthogonal 2 planes (oblique sagittal plane, oblique coronal plane) which were parallel to the longitudinal bone tunnel. We measured the diameters at 2 week and 1 year after surgery. Patients were classified into two groups: the preserving remnant group (28 patients) and the removing remnant group (12 patients). In this study we evaluated the bone tunnel widening, shape of tunnel widening and clinical outcomes including KT-2000 measurement.
Results
In the preserving remnant group, averaged the bone tunnel diameter of the femur side was wide up 1.4mm in oblique sagittal plane (OS) and 2.6mm in oblique coronal plane (OC). In the removing remnant group, that was wide up 1.1mm in OS and 1.9mm in OC. On the femur side, over 2mm widening bone tunnel was 71% in the preserving remnant group. That of removing remnant group was 58%. In the preserving remnant group, averaged the bone tunnel diameter of the tibial side was wide up 1.7mm in OS and 1.2mm in OC. In the removing remnant group, that was wide up 1.6mm in OS and 0.9mm in OC. On the tibial side, over 2mm widening bone tunnel was 46% in the preserving remnant group. That of removing remnant group was 41%. However, there was no significant difference with regards to the bone tunnel widening and shape of widening between two groups in the femur side, in the tibial side either. Difference of KT-2000 measurement between the operation side and the normal side was -0.1mm in the preserving remnant group, and 0.5mm in the removing remnant group. However there was no significant difference. Additionally there was no significant difference between two groups in clinical outcomes.
Conclusions
In the previous study using- X-ray, preserved remnant prevented bone tunnel widening in anatomical single bundle ACL reconstruction. However, this current study using CT showed preserved remnant did not affect the bone tunnel widening and clinical outcomes after anatomical single bundle ACL reconstruction. The effect of remnant preservation for anatomical double bundle ACL reconstruction should be needed to clarify in future.