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Significant anterior enlargement of femoral tunnel aperture after hamstring ACL reconstruction, compared to bone–patellar tendon–bone graft

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to retrospectively compare the enlargement and migration of the femoral tunnel aperture after anatomic rectangular tunnel anterior cruciate ligament (ACL) reconstruction with a bone–patella tendon–bone (BTB) or hamstring tendon (HT) graft using three-dimensional (3-D) computer models.

Methods

Thirty-two patients who underwent ACL reconstruction and postoperative computed tomography (CT) at 3 weeks and 6 months were included in this study. Of these, 20 patients underwent ACL reconstruction with a BTB graft (BTBR group), and the remaining 12 with an HT graft (HTR group). The area of the femoral tunnel aperture was extracted and measured using a 3-D computer model generated from CT images. Changes in the area and migration direction of the femoral tunnel aperture during this period were compared between the two groups.

Results

In the HTR group, the area of the femoral tunnel aperture was significantly increased at 6 months compared to 3 weeks postoperatively (P < 0.05). The average area of the femoral tunnel aperture at 6 months postoperatively was larger by 16.0 ± 12.4% in the BTBR group and 41.9 ± 22.2% in the HTR group, relative to that measured at 3 weeks postoperatively (P < 0.05). The femoral tunnel aperture migrated in the anteroinferior direction in the HTR group, and only in the inferior direction in the BTBR group.

Conclusions

The femoral tunnel aperture in the HTR group was significantly more enlarged and more anteriorly located at 6 months after ACL reconstruction, compared to the BTBR group.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Sports Orthopedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan

    Hiroshi Amano & Yoshinari Tanaka

  2. Depatment of Orthpaedics, JCHO Osaka Hospital, Osaka, Japan

    Keisuke Kita

  3. Department of Sports Orthopedics, Seifu Hospital, Sakai, Osaka, Japan

    Ryohei Uchida & Yoshiki Shiozaki

  4. Sports Orthopaedic Surgery Center, Yukioka Hospital, Osaka, Japan

    Yuta Tachibana

  5. Department of Orthopaedic Surgery, Hoshigaoka Medical Center, Osaka, Japan

    Yasukazu Yonetani

  6. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Tatsuo Mae

  7. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Osaka, Japan

    Shuji Horibe

Authors
  1. Hiroshi Amano
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  2. Yoshinari Tanaka
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  6. Yasukazu Yonetani
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  7. Tatsuo Mae
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  8. Yoshiki Shiozaki
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  9. Shuji Horibe
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Corresponding author

Correspondence to Hiroshi Amano.

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The authors declare that they have no conflict of interest.

Ethical aproval

This study has been approved by the Osaka Rosai Hospital Ethics committee of Japan Organization of Occupational Health and Safety (ID 20130729-5).

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Amano, H., Tanaka, Y., Kita, K. et al. Significant anterior enlargement of femoral tunnel aperture after hamstring ACL reconstruction, compared to bone–patellar tendon–bone graft. Knee Surg Sports Traumatol Arthrosc 27, 461–470 (2019). https://doi.org/10.1007/s00167-018-5098-9

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  • DOI: https://doi.org/10.1007/s00167-018-5098-9

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