ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Morphological changes of the femoral tunnel and their correlation with hamstring autograft maturation up to two years after ACL reconstruction using femoral cortical suspension

Shurong Zhang, MD, PhD, Shanghai, Shanghai CHINA
Department of Sports Medicine, Huashan Hospital, Shanghai, Shanghai, CHINA

FDA Status Not Applicable

Summary

Following ACLR using suspensory fixation, morphological changes of the femoral tunnel were mainly observed in the part of the tunnel containing the graft, which expanded at 6 months and reduced by 24 months. Expansion mainly occurred at the anterior-to-distal wall of the femoral tunnel. Femoral tunnel expansion correlated with inferior graft maturation but not with clinical outcomes.

ePosters will be available shortly before Congress

Abstract

Background

Graft healing within the femoral tunnel after anterior cruciate ligament reconstruction (ACLR) with suspensory fixation could be reflected in graft maturation and tunnel morphological changes. However, the correlation between graft maturation and femoral tunnel changes remains unclear.

Purpose

To quantitatively evaluate femoral tunnel morphological changes and graft maturation and to analyze their correlation after ACLR with femoral cortical suspension.

Methods

Patients who underwent single-bundle ACLR with hamstring tendon autograft using femoral cortical suspension were included. Preoperative and postoperative (at 6, 12, and 24 months) knee function was evaluated using KT-1000 testing, the Lysholm Knee Scoring Scale, and the International Knee Documentation Committee (IKDC) Questionnaire. At 1 day, 6 months, 12 months, and 24 months after ACLR, 3D magnetic resonance imaging (MRI) was performed to observe the morphology of the femoral tunnel and to evaluate graft maturation using the graft signal/noise quotient (SNQ). The correlation coefficients (CC) of femoral tunnel radii versus clinical outcomes and graft SNQs at last follow-up were analyzed.

Results

Twenty-two patients received full follow-up. KT-1000, Lysholm, and IKDC scores improved over time postoperatively, but no significant improvement was seen after 12 months (p < .05). The radius of the tunnel containing the graft and the SNQs of the femoral intraosseous graft and the intraarticular graft was the highest at 6 months and decreased by 24 months, but remained higher than their 1-day postoperative values (p < .05). Expansion mainly occurred at the anterior-to-distal wall of the femoral tunnel. Tunnel aperture radius positively correlated with SNQs of the intraosseous graft (CC: 0.591, p < .05) and the intraarticular graft (CC: 0.359, p < .05), but not with clinical outcomes.

Conclusion

Following ACLR using suspensory fixation, morphological changes of the femoral tunnel were mainly observed in the part of the tunnel containing the graft, which expanded at 6 months and reduced by 24 months. Expansion mainly occurred at the anterior-to-distal wall of the femoral tunnel. Femoral tunnel expansion correlated with inferior graft maturation but not with clinical outcomes.

↑