2021 ISAKOS Biennial Congress ePoster
Less tunnel enlargement in anatomical triple bundle anterior cruciate ligament reconstruction than in double bundle anterior cruciate ligament reconstruction in randomized clinical trial
Kousuke Shiwaku, MD, Sapporo, Hokkaido JAPAN
Tomoaki Kamiya, MD, Sapporo, Hokkaido JAPAN
Tomoyuki Suzuki, MD, PhD, Sapporo, Hokkaido JAPAN
Takashi Matsumura, MD, Sapporo Hokkaido JAPAN
Atsushi Teramoto, MD, PhD, Sapporo, Hokkaido JAPAN
Sapporo Medical University, Sapporo, Hokkaido, JAPAN
FDA Status Cleared
Summary
Less tunnel enlargement in anatomical triple bundle anterior cruciate ligament reconstruction than in double bundle anterior cruciate ligament reconstruction in randomized clinical trial
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Abstract
Introduction
There were no study comparing the tunnel enlargement of double bundle anterior cruciate ligament reconstruction (DB-ACLR) and triple bundle anterior cruciate ligament reconstruction (TB-ACLR). The primary purpose of this study was to compare the tibial tunnel enlargement of DB-ACLR and TB-ACLR in a prospective randomized clinical trial. The secondary purpose of this study was to compare the rate of tibial tunnel coalition of DB-ACLR and TB-ACLR. Our hypothesis was that tibial tunnel enlargement of TB-ACLR was less than DB-ACLR and the rate of tunnel coalition was equal.
Methods
In a randomized clinical trial, 25 patients were followed up and underwent computed tomography (CT) 2 weeks and 1 year after surgery and included in this study. Eleven patients underwent double bundle anterior cruciate ligament reconstruction and 14 patients underwent triple bundle anterior cruciate ligament reconstruction. Assessment of tunnel positions and tunnel coalition at the tibial tunnel aperture using three-dimensional CT. Also, tunnel enlargement rate as calculated by measuring the sagittal and axial widths of the tibial bone tunnel at 10 mm from tibial tunnel aperture. These parameters were compared between the two groups
Results
There were no significant differences in changes of the tunnel positions and tunnel coalitions between the two groups. In the sagittal view, the tunnel enlargement rates of the AMM and AML of TB-ACLR group were significantly smaller than AM of DB-ACLR group (p = .01 and <.01), while there was no significant difference between the PL tunnel enlargement of the two groups. Similarly, in the axial view, the tunnel enlargement raties of the AMM and AML of TB-ACLR group were significantly smaller than AM of DB-ACLR group (p = .01 and <.01), while there was no significant difference between the PL tunnel enlargement of the two groups.
Conclusion
This randomized clinical trial showed that there were less tunnel widening in the AMM and AML tibial tunnel of TB-ACLR groups than AM tibial tunnel of DB-ACLR groups. The possible reason may be the biomechanical advantages of TB-ACLR. Additionally, there were no significant differences of the rates of having any coalition between DB-ACLR and TB-ACLR groups.