2015 ISAKOS Biennial Congress ePoster #1206

Evaluation of Bone Healing After Anatomical Rectangular Tunnel ACL Reconstruction Using a Bone-Patellar Tendon-Bone Graft With Suspensory Fixation

Hironari Masuda, PhD, Tokyo JAPAN
Hiroshi Inui, PhD, Tokyo JAPAN
Shuji Taketomi, MD, PhD, Tokyo JAPAN
Takashi Matsushita, MD, DMSc, Tokyo JAPAN
Takumi Nakagawa, MD, PhD, Tokyo JAPAN

Teikyo University Hospital, Itabashi, Tokyo, JAPAN

FDA Status Cleared

Summary: Bone integration between bone plugs and bone tunnels after anatomical rectangular tunnel ACL reconstruction using BTB graft with suspensory fixation was evaluated by tomosynthesis. Bone plug-tunnel integration both in femoral side and tibia side was attained for every patient with suspensory fixation at a time of 5 months after operation.

Rate:

Abstract:

Background

In our facility Endo-button fixation is used for the femoral side fixation in anatomical rectangular tunnel ACL reconstruction using BTB graft (ART BTB ACL-R). Endo-button is used commonly for femoral side fixation in ACL reconstruction, but suspensory fixation such as Endo-button is thought to be less rigid than fixation using an interference screw. Despite a number of studies evaluate the timing of bone plug adhesion into bone tunnel after ACL reconstruction using a bone-patellar tendon-bone (BTB) graft, the necessary time for bone adhesion after ART BTB ACL-R with suspensory fixation remains to be elucidated.
Purpose The purpose of this study was to evaluate how long it takes for bone integration between bone plugs and bone tunnels after ART BTB ACL-R which was fixed with Endo-button for femoral side and DSP system for tibia side.
Method 50 patients underwent ART BTB ACL-R with distant fixations, Endo-button for femoral side and DSP system for tibia side. They were evaluated by tomosynthesis at 1, 3 and 5 months postoperatively. Image data were reconstructed to cross sectional images of coronal plane and sagittal plane at 2mm pitch, and bone adhesion were evaluated in both femoral side and tibia side. Statistical analyses were performed using the McNemar-test, with significance set at 0.05.
Results Rates of bone plugs adhesion into bone tunnels at 1, 3 and 5 months postoperatively were 0%, 53.1% and 100% respectively in femoral side, and 0%, 75% and 100% respectively in tibia side. At the time of 3 months after operation, the rate of adhesion in tibia side was significantly higher than femoral side (p=0.035).
Conclusions Our results showed that in spite of using distant fixations such as Endo-button and DSP system, bone plugs completely adhere into bone tunnels in 5 months at the latest after ART BTB ACL-R.