Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 5-Year Follow-Up

Arthroscopy. 2017 Dec;33(12):2184-2194. doi: 10.1016/j.arthro.2017.06.025. Epub 2017 Aug 16.

Abstract

Purpose: To radiographically assess the tibial tunnel up to 5 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 with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5 years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up.

Results: The mean follow-up period was 65 months (±3.9 months), with a minimum of 59 months. The width of the tibial tunnel on the anteroposterior view was 9.4 mm (±1.4 mm) in the early postoperative period and 9.2 mm (±1.5 mm) at 5 years (P = .64). The corresponding widths on the lateral view were 9.6 mm (±1.5 mm) in the early postoperative period and 9.0 mm (±1.4 mm) at 5 years (P = .014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5 years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment.

Conclusions: In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5 years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws.

Level of evidence: Level II, prospective study.

MeSH terms

  • Absorbable Implants / adverse effects
  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Autografts
  • Bone Screws / adverse effects
  • Female
  • Follow-Up Studies
  • Hamstring Tendons / transplantation*
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Lysholm Knee Score
  • Male
  • Middle Aged
  • Prospective Studies
  • Range of Motion, Articular
  • Tibia / diagnostic imaging
  • Tibia / surgery*
  • Transplantation, Autologous
  • Young Adult