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Erschienen in: Archives of Orthopaedic and Trauma Surgery 11/2016

06.08.2016 | Arthroscopy and Sports Medicine

Computed tomography value and tunnel enlargement of round and rounded rectangular femoral bone tunnel for anterior cruciate ligament reconstruction

verfasst von: Yasushi Takata, Junsuke Nakase, Hitoaki Numata, Takeshi Oshima, Hiroyuki Tsuchiya

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 11/2016

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Abstract

Introduction

We developed a novel technique for anatomical single-bundle anterior cruciate ligament (ACL) reconstruction: creation of a rounded rectangular femoral bone tunnel. The purpose of this study was to compare the computed tomography (CT) value and tunnel enlargement ratio of the femoral bone tunnel with those of round tunnel ACL reconstruction.

Materials and methods

We included 39 knees that underwent round tunnel ACL reconstruction and 42 that underwent rounded rectangular ACL reconstruction. To evaluate the CT value, we compared the CT images approximately 1 week after surgery. Making a parallel slice toward the opening of bone tunnels to a depth of 3 mm, we evaluated the CT value of eight directions in the bone tunnel wall. To evaluate tunnel enlargement, we compared CT images approximately 1 week after surgery with images taken 3 months after surgery. Using a parallel slice toward the opening of the bone tunnel, we measured the bone tunnel area and calculated the tunnel enlargement ratio. The level of significance was P < 0.05, and the t test was used for statistical analyses.

Results

The CT value was significantly increased for the rounded rectangular tunnel in comparison with the round tunnel in almost all directions (P < 0.05). The rounded rectangular tunnel area enlargement ratio was significantly lower (round, 110 ± 38 %; rounded rectangular, 73 ± 37 %; P = 0.001).

Conclusion

The rounded rectangular tunnel could have a compression effect on the cancellous bone and reduce enlargement of the bone tunnel.
Literatur
1.
Zurück zum Zitat L’Insalata JC, Klatt B, Fu FH, Harner CD (1997) Tunnel expansion following anterior cruciate ligament reconstruction: a comparison of hamstring and patellar tendon autografts. Knee Surg Sports Traumatol Arthrosc 5:234–238CrossRefPubMed L’Insalata JC, Klatt B, Fu FH, Harner CD (1997) Tunnel expansion following anterior cruciate ligament reconstruction: a comparison of hamstring and patellar tendon autografts. Knee Surg Sports Traumatol Arthrosc 5:234–238CrossRefPubMed
2.
Zurück zum Zitat Höher J, Möller HD, Fu FH (1998) Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surg Sports Traumatol Arthrosc 6:231–240CrossRefPubMed Höher J, Möller HD, Fu FH (1998) Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surg Sports Traumatol Arthrosc 6:231–240CrossRefPubMed
3.
Zurück zum Zitat Vergis A, Gilquist J (1995) Graft failure in intra-articular anterior cruciate ligament reconstructions: a review of the literature. Arthroscopy 11:312–321CrossRefPubMed Vergis A, Gilquist J (1995) Graft failure in intra-articular anterior cruciate ligament reconstructions: a review of the literature. Arthroscopy 11:312–321CrossRefPubMed
4.
Zurück zum Zitat Fahey M, Indelicato PA (1994) Bone tunnel enlargement after anterior cruciate ligament replacement. Am J Sports Med 22:410–414CrossRefPubMed Fahey M, Indelicato PA (1994) Bone tunnel enlargement after anterior cruciate ligament replacement. Am J Sports Med 22:410–414CrossRefPubMed
5.
Zurück zum Zitat Petersen W, Forkel P, Achtnich A, Metzlaff S, Zantop T (2013) Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers. Arch Orthop Trauma Surg 133:827–833. doi:10.1007/s00402-013-1741-6 CrossRefPubMed Petersen W, Forkel P, Achtnich A, Metzlaff S, Zantop T (2013) Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers. Arch Orthop Trauma Surg 133:827–833. doi:10.​1007/​s00402-013-1741-6 CrossRefPubMed
6.
Zurück zum Zitat Segawa H, Omori G, Tomita S, Koga Y (2001) Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 9:206–210CrossRefPubMed Segawa H, Omori G, Tomita S, Koga Y (2001) Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 9:206–210CrossRefPubMed
7.
Zurück zum Zitat Iorio R, Vadalà A, Argento G, Di Sanzo V, Ferretti A (2007) Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study. Int Orthop 31:49–55CrossRefPubMed Iorio R, Vadalà A, Argento G, Di Sanzo V, Ferretti A (2007) Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study. Int Orthop 31:49–55CrossRefPubMed
8.
Zurück zum Zitat Wilson TC, Kantaras A, Atay A, Johnson DL (2004) Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med 32:543–549CrossRefPubMed Wilson TC, Kantaras A, Atay A, Johnson DL (2004) Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med 32:543–549CrossRefPubMed
9.
Zurück zum Zitat Cheung P, Chan WL, Yen CH, Cheng SC, Woo SB, Wong TK, Wong WC (2010) Femoral tunnel widening after quadrupled hamstring anterior cruciate ligament reconstruction. J Orthop Surg (Hong Kong) 18:198–202CrossRef Cheung P, Chan WL, Yen CH, Cheng SC, Woo SB, Wong TK, Wong WC (2010) Femoral tunnel widening after quadrupled hamstring anterior cruciate ligament reconstruction. J Orthop Surg (Hong Kong) 18:198–202CrossRef
10.
Zurück zum Zitat Ugutmen E, Ozkan K, Güven M, Sener N, Altintas F (2007) Early tunnel enlargement after arthroscopic ACL reconstructions. Acta Orthop Belg 73:625–629PubMed Ugutmen E, Ozkan K, Güven M, Sener N, Altintas F (2007) Early tunnel enlargement after arthroscopic ACL reconstructions. Acta Orthop Belg 73:625–629PubMed
12.
Zurück zum Zitat Sasaki N, Ishibashi Y, Tsuda E, Yamamoto Y, Maeda S, Mizukami H, Toh S, Yagihashi S, Tonosaki Y (2012) The femoral insertion of the anterior cruciate ligament: discrepancy between macroscopic and histological observations. Arthroscopy 28:1135–1146. doi:10.1016/j.arthro.2011.12.021 CrossRefPubMed Sasaki N, Ishibashi Y, Tsuda E, Yamamoto Y, Maeda S, Mizukami H, Toh S, Yagihashi S, Tonosaki Y (2012) The femoral insertion of the anterior cruciate ligament: discrepancy between macroscopic and histological observations. Arthroscopy 28:1135–1146. doi:10.​1016/​j.​arthro.​2011.​12.​021 CrossRefPubMed
13.
Zurück zum Zitat Smigielski R, Zdanowicz U, Drwięga M, Ciszek B, Ciszkowska-Łysoń B, Siebold R (2015) Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees. Knee Surg Sports Traumatol Arthrosc 23:3143–3150. doi:10.1007/s00167-014-3146-7 CrossRefPubMed Smigielski R, Zdanowicz U, Drwięga M, Ciszek B, Ciszkowska-Łysoń B, Siebold R (2015) Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees. Knee Surg Sports Traumatol Arthrosc 23:3143–3150. doi:10.​1007/​s00167-014-3146-7 CrossRefPubMed
15.
Zurück zum Zitat Nakase J, Toratani T, Kosaka M, Ohashi Y, Numata H, Oshima T, Takata Y, Tsuchiya H (2015) Technique of anatomical single bundle ACL reconstruction with rounded rectangle femoral dilator. Knee. doi:10.1016/j.knee.2015.07.005 (Epub ahead of print) PubMed Nakase J, Toratani T, Kosaka M, Ohashi Y, Numata H, Oshima T, Takata Y, Tsuchiya H (2015) Technique of anatomical single bundle ACL reconstruction with rounded rectangle femoral dilator. Knee. doi:10.​1016/​j.​knee.​2015.​07.​005 (Epub ahead of print) PubMed
16.
Zurück zum Zitat Tie K, Wang H, Wang X, Chen L (2012) Measurement of bone mineral density in the tunnel regions for anterior cruciate ligament reconstruction by dual-energy X-ray absorptiometry, computed tomography scan, and the immersion technique based on Archimedes’ principle. Arthroscopy 28:1464–1471. doi:10.1016/j.arthro.2012.04.053 (Erratum in: Arthroscopy 2013; 29:189) CrossRefPubMed Tie K, Wang H, Wang X, Chen L (2012) Measurement of bone mineral density in the tunnel regions for anterior cruciate ligament reconstruction by dual-energy X-ray absorptiometry, computed tomography scan, and the immersion technique based on Archimedes’ principle. Arthroscopy 28:1464–1471. doi:10.​1016/​j.​arthro.​2012.​04.​053 (Erratum in: Arthroscopy 2013; 29:189) CrossRefPubMed
17.
Zurück zum Zitat Kawai R, Tsukahara K, Yamaga A, Hiraiwa H, Sakai T, Yamaga H (2014) The effect of dilation to CT value of PL femoral tunnel wall. JOSKAS 39:114–115 Kawai R, Tsukahara K, Yamaga A, Hiraiwa H, Sakai T, Yamaga H (2014) The effect of dilation to CT value of PL femoral tunnel wall. JOSKAS 39:114–115
18.
Zurück zum Zitat Mariscalco MW, Flanigan DC, Mitchell J, Pedroza AD, Jones MH, Andrish JT, Parker RD, Kaeding CC, Magnussen RA (2013) The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy 29:1948–1953. doi:10.1016/j.arthro.2013.08.025 CrossRefPubMed Mariscalco MW, Flanigan DC, Mitchell J, Pedroza AD, Jones MH, Andrish JT, Parker RD, Kaeding CC, Magnussen RA (2013) The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy 29:1948–1953. doi:10.​1016/​j.​arthro.​2013.​08.​025 CrossRefPubMed
20.
21.
Zurück zum Zitat Webster KE, Feller JA, Elliott J, Hutchison A, Payne R (2004) A comparison of bone tunnel measurements made using computed tomography and digital plain radiography after anterior cruciate ligament reconstruction. Arthroscopy 20:946–950CrossRefPubMed Webster KE, Feller JA, Elliott J, Hutchison A, Payne R (2004) A comparison of bone tunnel measurements made using computed tomography and digital plain radiography after anterior cruciate ligament reconstruction. Arthroscopy 20:946–950CrossRefPubMed
22.
Zurück zum Zitat Ito MM, Tanaka S (2006) Evaluation of tibial bone-tunnel changes with X-ray and computed tomography after ACL reconstruction using a bone-patella tendon-bone autograft. Int Orthop 30:99–103CrossRefPubMedPubMedCentral Ito MM, Tanaka S (2006) Evaluation of tibial bone-tunnel changes with X-ray and computed tomography after ACL reconstruction using a bone-patella tendon-bone autograft. Int Orthop 30:99–103CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Fink C, Zapp M, Benedetto KP, Hackl W, Hoser C, Rieger M (2001) Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft. Arthroscopy 17:138–143CrossRefPubMed Fink C, Zapp M, Benedetto KP, Hackl W, Hoser C, Rieger M (2001) Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft. Arthroscopy 17:138–143CrossRefPubMed
25.
Zurück zum Zitat Basson B, Philippot R, Neri T, Meucci JF, Boyer B, Farizon F (2015) The effect of femoral tunnel widening on one-year clinical outcome after anterior cruciate ligament reconstruction using ZipLoop® technology for fixation in the cortical bone of the femur. Knee. doi:10.1016/j.knee.2015.06.002 (Epub ahead of print) PubMed Basson B, Philippot R, Neri T, Meucci JF, Boyer B, Farizon F (2015) The effect of femoral tunnel widening on one-year clinical outcome after anterior cruciate ligament reconstruction using ZipLoop® technology for fixation in the cortical bone of the femur. Knee. doi:10.​1016/​j.​knee.​2015.​06.​002 (Epub ahead of print) PubMed
26.
Zurück zum Zitat Robinson J, Huber C, Jaraj P, Colombet P, Allard M, Meyer P (2006) Reduced bone tunnel enlargement post hamstring ACL reconstruction with poly-l-lactic acid/hydroxyapatite bioabsorbable screws. Knee 13:127–131CrossRefPubMed Robinson J, Huber C, Jaraj P, Colombet P, Allard M, Meyer P (2006) Reduced bone tunnel enlargement post hamstring ACL reconstruction with poly-l-lactic acid/hydroxyapatite bioabsorbable screws. Knee 13:127–131CrossRefPubMed
27.
Zurück zum Zitat Fules PJ, Madhav RT, Goddard RK, Newman-Sanders A, Mowbray MAS (2003) Evaluation of tibial bone tunnel enlargement using MRI scan cross-sectional area measurement after autologous hamstring tendon ACL replacement. Knee 10:87–91CrossRefPubMed Fules PJ, Madhav RT, Goddard RK, Newman-Sanders A, Mowbray MAS (2003) Evaluation of tibial bone tunnel enlargement using MRI scan cross-sectional area measurement after autologous hamstring tendon ACL replacement. Knee 10:87–91CrossRefPubMed
29.
Zurück zum Zitat Marchant MH Jr, Willimon SC, Vinson E, Pietrobon R, GarrettWE Higgins LD (2010) Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1059–1064CrossRefPubMed Marchant MH Jr, Willimon SC, Vinson E, Pietrobon R, GarrettWE Higgins LD (2010) Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1059–1064CrossRefPubMed
Metadaten
Titel
Computed tomography value and tunnel enlargement of round and rounded rectangular femoral bone tunnel for anterior cruciate ligament reconstruction
verfasst von
Yasushi Takata
Junsuke Nakase
Hitoaki Numata
Takeshi Oshima
Hiroyuki Tsuchiya
Publikationsdatum
06.08.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 11/2016
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2541-6

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