Summary

There was no correlation seen between bone tunnel widening and clinical outcome following arthrscopic ACL reconstruction.

Abstract

Introduction

A common complication of ACL Reconstruction surgery is bone tunnel enlargement. The cause of tunnel widening is thought to be multifactorial, including a combination of mechanical and biological factors. From a scientific standpoint, comprehensive clinical and radiographic assessment of postoperative knees following ACL Reconstruction is critical to understand the correlation between clinical and radiological findings after ACL reconstruction surgery.

Materials And Methods

Our retrospective study comprised of 23 individuals between the age of 18 and 45 who visited the Sports Clinic at a tertiary care hospital and underwent ACL reconstruction. During the follow-up appointment at 1 year postoperatively, clinical and radiological assessments were performed. To estimate tunnel widening, the diameters of the tibial and femoral tunnels were measured at different locations within the tunnel using CT scan of the operated knee and compared to intra operative tunnel diameters. The patients were also clinically assessed using Knee Laxity tests and scored using the IKDC and Lysholm criteria. The results were compared to preoperative functional knee ratings. Patients aged between 18-45 years, who had undergone ACL Reconstruction surgery using hamstring or peroneus longus graft within the last two years by the same surgeon were included in this study. Only patients with at least 1year postoperative period were planned for CT scan of the knee and included in the study. The patients with revision surgeries were excluded from the study.

Results

The tibial and femoral tunnel diameter enlarged significantly (p<0.05) at their apertures and in the middle of the tunnel after ACL reconstruction. Significant improvement (p<0.05) was seen in knee laxity from preoperative to post-operative stage for Lachman test. Knee functionality score (IKDC and Lysholm score) significantly (p<0.05) improved from preoperative to post-operative stage. The current study showed that femoral and tibial tunnel widening had no effect on clinical outcomes.

Conclusion

Both tibial and femoral tunnels showed the largest enlargement at the aperture, followed by the center of the tunnel. However, the Knee functionality score (IKDC and Lysholm score) were not affected by tunnel widening. This indicates that there was no correlation present between tunnel widening and clinical outcome following ACL reconstruction. However, given the limited sample size of this study, there is further need to investigate these parameters.