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Femoral posterolateral tunnel aperture widened more in double-bundle ACL reconstruction
Patients who underwent double-bundle reconstruction of the ACL experienced significantly more widening in the femoral posterolateral tunnel aperture compared with the anteromedial tunnel aperture in double-bundle reconstruction and the femoral tunnel aperture in bone-patellar tendon-bone grafts, according to study results.
Researchers retrospectively reviewed data for 52 patients who underwent isolated ACL reconstruction and had tunnel measurements obtained by computed tomography. Double-bundle reconstruction (DBR) of the ACL using hamstrings in 26 patients was compared with 26 patients in whom rectangular tunnel ACL reconstruction was performed using bone-patellar tendon-bone grafts (BPTBR).
The researchers investigated femoral tunnel aperture positioning and tunnel widening (TW) using 3-D CT images at 1 week and 1 year postoperatively.
Compared with 1 week after surgery, the average diameter of the anteromedial femoral tunnel increased by 34% horizontally and 28.2% vertically in DBR at 1 year postoperatively, whereas the posterolateral femoral tunnel increased by 58.2% horizontally and 73.4% vertically. The researchers found significantly greater TW value percentage of the posterolateral tunnel compared with the anteromedial tunnel.
The average diameter in BPTBR increased by 22% horizontally and 17.1% vertically, and the researchers found a significantly greater TW value percentage of the posterolateral tunnel in DBR compared with the femoral tunnel in BPTBR.
Although each tunnel aperture migrated distally in the horizontal direction and high in the vertical direction, anteromedial and posterolateral tunnel apertures migrated in the vertical direction in DBR significantly more compared with the BPTBR, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.