Lateral posterior tibial slope does not affect femoral but does affect tibial tunnel widening following anatomic anterior cruciate ligament reconstruction using a Bone-Patellar Tendon-Bone graft

Shuji Taketomi; Hiroshi Inui; Ryota Yamagami; Keiu Nakazato; Kohei Kawaguchi; Kenichi Kono; Shin Sameshima; Tomofumi Kage; Sakae Tanaka

doi:10.1016/j.asmart.2022.09.003

Lateral posterior tibial slope does not affect femoral but does affect tibial tunnel widening following anatomic anterior cruciate ligament reconstruction using a Bone-Patellar Tendon-Bone graft

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2022 Oct 5:30:25-31. doi: 10.1016/j.asmart.2022.09.003. eCollection 2022 Oct.

Authors

Shuji Taketomi¹, Hiroshi Inui¹, Ryota Yamagami¹, Keiu Nakazato¹, Kohei Kawaguchi¹, Kenichi Kono¹, Shin Sameshima¹, Tomofumi Kage¹, Sakae Tanaka¹

Affiliation

¹ Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Abstract

Background: Tunnel widening (TW) after anterior cruciate ligament (ACL) reconstruction has been a research area of interest in ACL reconstruction. In recent years, it has been noted that posterior tibial slope (PTS) affects several types of outcomes after ACL reconstruction including TW. However, the relationships between femoral and tibial TW and between PTS and TW following anatomical ACL reconstruction using a bone-patellar tendon-bone (BTB) graft are often not understood. Therefore, the purpose of this study was to retrospectively clarify the magnitude of femoral and tibial TW and the effect of PTS on TW following anatomical ACL reconstruction using a BTB graft.

Methods: A total of 111 patients who underwent isolated ACL reconstructions using BTB grafts were included in this study. Femoral and tibial tunnel aperture areas were measured using three-dimensional computed tomography (3D CT) at 1 week and 1 year postoperatively, and femoral and tibial TW (%) was calculated. Lateral and medial PTS was also measured using 3D CT.

Results: As compared with 1 week postoperatively, the mean tibial tunnel aperture areas increased by 30.6% ± 28.5%, and the mean femoral tunnel aperture areas increased by 28.3% ± 27.9% when measured at 1 year postoperatively. Although no significant difference was observed between femoral and tibial TW, a significant positive correlation was noted between femoral and tibial TW (r = 0.240, p = 0.011). A significant correlation was observed only between lateral PTS and tibial TW (r = 0.354, p < 0.001). There was no significant correlation between medial PTS and tibial TW, lateral PTS and femoral TW, or medial PTS and femoral TW.

Conclusion: Significant positive correlation was observed between femoral and tibial TW. Steeper lateral PTS correlated with greater tibial TW; on the other hand, medial PTS did not correlate with tibial TW. Although lateral PTS affected tibial TW, it did not affect femoral TW.

Keywords: Anterior cruciate ligament; Bone–patellar tendon–bone graft; Lateral posterior tibial slope; Tunnel widening.