A Radiographic Investigation into the Impact of Graft Size and Time From Injury to Surgery on Static Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction

A Radiographic Investigation into the Impact of Graft Size and Time From Injury to Surgery on Static Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction

Tomas Pineda, MD, CHILE Nicolas Cance, MD, FRANCE Michael J. Dan, Mbbs, PhD, MSc(res), FRACS(oath), AUSTRALIA Guillaume Demey, MD, FRANCE David H. Dejour, MD, FRANCE

Clinique de la Sauvegarde, Lyon, FRANCE


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Diagnosis Method

Sports Medicine


Summary: Graft size and time from injury to surgery do not significantly affect the reduction of static anterior tibial translation or dynamic anterior tibial translation following ACL reconstruction


Background

Increased anterior tibial translation has been associated with increased posterior tibial slope (PTS) and increased graft failure. Tibial Deflection Osteotomy (TDO) is the only treatment that has shown significant reduction in Static Anterior Tibial Translation (SATT), however, the impact of other variables needs to be studied.

Purpose

The aim of this study is to evaluate the impact of graft size and time between injury to surgery (TBIS) on SATT and dynamic anterior tibial translation (DATT) after anterior cruciate ligament (ACL) reconstruction.

Methods

A consecutive series of patients treated with primary ACL reconstruction using hamstring autograft was reviewed. Preoperative SATT, DATT, and PTS were measured with a previously validated technique by 2 independent reviewers on lateral weight-bearing knee radiographs. Regression analysis was performed to assess the relationship between Postoperative - Preoperative SATT Difference (? SATT), and Postoperative - Preoperative DATT Difference (? DATT) with graft size and time to surgery.

Results

In total, 62 patients were included in this study. The mean preoperative SATT and DATT were 2.41 (SD 2.98) and 9.09 (SD 3.19), respectively. The mean postoperative SATT and DATT were 2.14 (SD 2.47) and 5.28 (SD 2.55), respectively. The mean graft size was 8.4 mm (range 7.75 to 10) and the mean TBIS was 14.95 months (range 1 to 275). Linear regression analysis showed no correlation between graft size and ? SATT (p=0.060) and ? DATT (p=0.979) and no correlation between TBIS and ? SATT (p=0.817) and ? DATT (p=0.811). There was a significant correlation between preoperative SATT and PTS (p < 0.014), with a Pearson correlation coefficient of 0.302. No correlation was found between preoperative DATT and PTS (p = 0.489).

Conclusion

Our findings suggest that graft size and TBIS do not significantly affect the reduction of SATT or DATT following ACL reconstruction. This supports the notion that increased preoperative SATT and DATT should not be an indication for the use of larger grafts.