Effects of initial graft tension on femoral tunnel widening after anatomic anterior cruciate ligament reconstruction using a bone–patellar tendon–bone graft

Introduction The effects of initial graft tension upon tunnel widening (TW) following anatomic anterior cruciate ligament (ACL) reconstruction have not been elucidated. The purpose of this study was to retrospectively investigate the effect of two different graft-tensioning protocols upon femoral TW...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2017-09, Vol.137 (9), p.1285-1291
Main Authors: Taketomi, Shuji, Inui, Hiroshi, Tahara, Keitaro, Shirakawa, Nobuyuki, Tanaka, Sakae, Nakagawa, Takumi
Format: Article
Language:English
Subjects:
Anterior Cruciate Ligament - diagnostic imaging
Anterior Cruciate Ligament - surgery
Anterior Cruciate Ligament Reconstruction - methods
Anterior Cruciate Ligament Reconstruction - statistics & numerical data
Arthroscopy and Sports Medicine
Bone-Patellar Tendon-Bone Grafts - physiology
Bone-Patellar Tendon-Bone Grafts - surgery
Humans
Knee
Knee Joint - diagnostic imaging
Knee Joint - physiology
Knee Joint - surgery
Medicine
Medicine & Public Health
Orthopedics
Patellar Ligament - diagnostic imaging
Patellar Ligament - physiology
Patellar Ligament - surgery
Retrospective Studies
Tomography, X-Ray Computed
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Summary:Introduction The effects of initial graft tension upon tunnel widening (TW) following anatomic anterior cruciate ligament (ACL) reconstruction have not been elucidated. The purpose of this study was to retrospectively investigate the effect of two different graft-tensioning protocols upon femoral TW following anatomic ACL reconstruction using a bone–patellar tendon–bone (BPTB) graft and a three-dimensional (3D) computed tomography (CT) model. Methods Forty-three patients who underwent isolated ACL reconstruction using BPTB grafts were included in this study. In 18 out of the 43 patients, the graft was fixed at full knee extension with manual maximum pull (Group H). These patients were compared with 25 patients in whom the BPTB graft was fixed at full knee extension with 80-N pull (Group L). Tunnel aperture area was measured using 3D CT 1 week and 1 year postoperatively, thus enabling us to calculate the percentage change in the area of femoral tunnel aperture. Clinical assessment was performed 1 year postoperatively, corresponding to the time period of CT assessment, and involved the evaluation of Lysholm score, anterior knee stability using a KneeLax3 arthrometer, and the pivot-shift test. Results When measured at 1 year postoperatively, the mean area of the femoral tunnel aperture had increased by 78.6 ± 36.8% in Group H when compared with at 1 week postoperatively, whereas that of Group L had increased by 27.7 ± 32.3%. Furthermore, TW (%) in Group H was significantly greater than that of Group L ( P  
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-017-2728-5