Minimal tibial tunnel enlargement after anatomic rectangular tunnel anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft

Okimura, Shinichiro; Shino, Konsei; Nakagawa, Shigeto; Iuchi, Ryo; Take, Yasuhiro; Mae, Tatsuo

doi:10.1016/j.jos.2019.07.001

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Most studies that have investigated the relationship between the bone plug depth and tunnel enlargement have demonstrated a significantly positive correlation between the two on the femoral side, but not the tibial side. 3 , 4 , 10 , 25 Reported correlations between the two on the tibial side have varied. In our study, bone plug depth was positively correlated with the tunnel enlargement rate on both the femoral and tibial sides.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Theoretically, tunnel enlargement can allow graft migration owing to delayed graft healing within the tunnel, which can lead to graft failure and recurrent instability. 8 , 10 Järvelä et al. reported a correlation between tunnel enlargement and anterior knee laxity.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 Although some studies have found a positive correlation between the deep tibial bone plug position tibial tunnel aperture enlargement, 3 , 25 others have not. 4 , 10 Uchida et al. reported a definite correlation between femoral bone plug depth (FBPD) and femoral tunnel aperture enlargement and that the femoral tunnel aperture was more susceptible to enlargement than the tibial one.…”

Section: Introductionmentioning

confidence: 99%

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Increased Bone Plug Depth From the Joint Increases Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Suspensory Femoral Fixation

Kurihara¹,

Takahashi²,

Hagiwara³

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased Bone Plug Depth From the Joint Increases Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Suspensory Femoral Fixation

Kurihara¹,

Takahashi²,

Hagiwara³

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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“…The distinct features of this procedure are creating the rectangular tunnel apertures inside the anatomical attachment areas and closely mimicking the ibre arrangement of the native ACL [29][30][31]. Some studies have reported good clinical outcomes after ART ACL reconstruction with a BTB graft [21,23,24,34,37]. However, these reports unfortunately had drawbacks, such as a small number of patients and a low follow-up rate.…”

Section: Discussionmentioning

confidence: 99%

Anatomical rectangular tunnel anterior cruciate ligament reconstruction provides excellent clinical outcomes

Matsuo

Kusano

Uchida

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to prospectively evaluate the clinical outcomes following anatomical rectangular tunnel anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone (BTB) graft using an adjustablelength femoral cortical ixation device with enough patients and a high follow-up rate. Methods This study included 125 patients who underwent anatomical rectangular tunnel ACL reconstruction with a BTB graft. A BTB TightRope ® was used for femoral graft ixation. Clinical evaluations were performed more than 2 years after surgery using the International Knee Documentation Committee (IKDC) Form. Patients interviewed by telephone were only subjectively evaluated. The side-to-side diference in anterior laxity at a manual maximum force was measured using the KT-2000 Arthrometer ® . Results Among the 125 patients, 99 were ultimately included and 26 were lost to follow-up (follow-up rate: 79%). Eight patients had re-tear (re-tear rate: 8%) and six patients had ACL injuries to the contralateral knee. Three patients did not follow our rehabilitation programme. One patient sufered septic arthritis. These 18 patients were considered ineligible for clinical evaluations. Therefore, clinical evaluations were performed in 81 of the 99 patients (64 were available for direct follow-up and 17 were available for a telephone interview). The follow-up period was 30 ± 10 months (range 24-68 months). According to the IKDC subjective assessment, 48 (59%) and 33 (41%) knees were graded as normal and nearly normal, respectively. A loss of extension (3°-5°) was observed in ive patients (8%), whereas one patient (2%) exhibited a loss of lexion (3°-5°). The Lachman test was negative in 63 patients (98%). The pivot shift test was negative in 59 patients (92%). The side-to-side diference in KT value was 0.4 ± 0.7 mm (range − 1-4 mm). Conclusion Anatomical rectangular tunnel ACL reconstruction with a BTB graft using an adjustable-length femoral cortical ixation device provided excellent clinical outcomes both subjectively and objectively more than 2 years after surgery, whereas 8 of the 99 patients had re-tear of the graft. The adjustable-length femoral cortical ixation device could be safely used in anatomical rectangular tunnel ACL reconstruction with a BTB graft. Level of evidence III

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“…Moreover, the use of a rectangular dilator makes it possible to increase the graft size and cross‐sectional area without causing roof impingement and heating the bone [42, 48, 58, 59]. ACL reconstruction using a rectangular dilator showed good clinical outcomes [42, 45, 53, 58, 59], but no study has reported on PCL reconstruction using the rectangular dilator. As the footprint area of the PCL is known to be larger than that of the ACL [43, 51, 62] and the shape of the PCL footprint was oval [3, 4, 11, 43], using a rectangular dilator in PCL reconstruction might have advantages in terms of clinical outcomes and stability.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of rectangular tunnel technique in posterior cruciate ligament reconstruction were comparable to the results of conventional round tunnel technique

Kim

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare clinical outcomes between the conventional round and rectangular tunnel techniques in single‐bundle posterior cruciate ligament (PCL) reconstruction. MethodsTwenty‐seven and 108 patients who underwent PCL reconstructions using a rectangular dilator (Group 1) and rounded tunnel reamer (Group 2), respectively, were included. The exclusion criteria were having a concomitant fracture, osteotomy, subtotal or total meniscectomy, and no remnant PCL tissue. A 4:1 propensity score matching was performed. The knee laxity on stress radiography, International Knee Documentation Committee Subjective Knee Evaluation score, Tegner activity score and Orthopädische Arbeitsgruppe Knie score were evaluated. ResultsNo significant differences were found between the groups in terms of clinical scores. (n.s.) The mean posterior translations were also not significantly different between the Group 1 and 2 (3.6 ± 2.8 and 3.8. ± 3.1 mm, respectively; n.s.). However, 3 patients (11.1%) in Group 1 and 15 patients (13.8%) in Group 2 showed posterior translation of > 5 mm. The combined posterolateral corner sling technique was performed for 27 patients (100%) in Group 1 and for 96 patients (88.9%) in Group 2. We found no significant difference in rotational stability at the final follow‐up. One patient was found to have a femoral condyle fracture during rectangular femoral tunnel establishment, which was healed after screw fixation, without laxity, during follow‐up. The intra‐ and inter‐observer reliabilities of the radiological measurements ranged from 0.81 to 0.89. ConclusionArthroscopic anatomical remnant‐preserving PCL reconstruction using a rectangular dilator showed satisfactory clinical results and stability as compared with PCL reconstruction using a conventional rounded reamer. Rectangular tunnel technique in PCL reconstruction could be a good treatment option with theoretical advantage to be anatomic. Level of evidenceLevel IV.

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Minimal tibial tunnel enlargement after anatomic rectangular tunnel anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft

Cited by 6 publications

References 16 publications

Increased Bone Plug Depth From the Joint Increases Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Suspensory Femoral Fixation

Increased Bone Plug Depth From the Joint Increases Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Suspensory Femoral Fixation

Anatomical rectangular tunnel anterior cruciate ligament reconstruction provides excellent clinical outcomes

Clinical outcomes of rectangular tunnel technique in posterior cruciate ligament reconstruction were comparable to the results of conventional round tunnel technique

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