2017 ISAKOS Biennial Congress ePoster #1106

 

Radiographic Tibial Tunnel Assessment after Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study with Five-Year Follow-Up

Ioannis Karikis, MD, PhD, Uddevalla SWEDEN
Lars Ejerhed, MD, PhD, Trollhättan SWEDEN
Ninni Sernert, PhD, RPT, Trollhättan SWEDEN
Lars Rostgård, MD, Trollhättan SWEDEN
Jüri T. Kartus, MD, PhD, Trollhättan SWEDEN

NU-Hospital Group, Trollhättan/Uddevalla, SWEDEN

FDA Status Cleared

Summary

In the majority of patients, no tunnel enlargement was found on the tibial side five years after ACL reconstruction using biocomposite interference screws. No correlation was found between the tunnel widths and the laxity at five years.

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Abstract

Purpose

Radiographically to assess the tibial tunnel up to five years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws.

Methods

Fifty-one patients underwent anatomic single-bundle ACL reconstruction using metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior (AP) and lateral views of the index knee were taken in the early postoperative period and at two and five years postoperatively. At three points perpendicular to the length axis of the tunnel, one at each end and one in the center of the tunnel, in both the AP and lateral views, the width was measured. The mean value of the three measurements in each projection was calculated and defined as the width of the tunnel. Forty of 51 (78%) patients underwent radiographic assessment on all three occasions. Subjective and objective clinical assessments were obtained preoperatively and at the five-year follow-up.

Results

The mean follow-up was 65 months (+/-3.9). The width of the tibial tunnel in the AP view was 9.4 mm (+/-1.4) in the early postoperative period and 9.2 (+/-1.5) at five years; p=0.64. The corresponding figures in the lateral view were 9.6 (+/-1.5) in the early postoperative period and 9.0 (+/-1.4) at five years; p=0.014. In 6/40 (15%) patients, the width of the tunnel was greater at five years than in the early postoperative period in both the AP and lateral projections. The study group had improved significantly at the five-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests, the pivot-shift test, the Tegner activity scale and the Lysholm knee score (p<0.001). No correlations were found between the tunnel widths and the KT-1000 assessment.

Conclusion

In the majority of patients, no tunnel enlargement was found on the tibial side five years after ACL reconstruction using biocomposite interference screws.