The effect of femoral tunnel widening on one-year clinical outcome after anterior cruciate ligament reconstruction using ZipLoop® technology for fixation in the cortical bone of the femur

Basson, Benjamin; Philippot, Rémi; Néri, Thomas; Meucci, Jean François; Boyer, Bertrand; Farizon, Frédéric

doi:10.1016/j.knee.2015.06.002

Cited by 18 publications

(13 citation statements)

References 24 publications

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“…On the other hand, the enlargement rate decreased gradually from the aperture toward the inside of the tunnel, and the tunnel shape was conical as with previous reports of tunnel enlargement after ACL reconstruction with hamstring tendon grafts (Araki et al, 2014 ; Basson et al, 2016 ; Fules et al, 2003 ; Lee et al, 2012 ). The hamstring tendon graft is typically fixed extra-cortically using suspensory fixation devices, and the graft moves within the tunnel around the extra-cortical fixation point as a fulcrum.…”

Section: Discussionsupporting

confidence: 87%

“…However, these evaluations have been performed by measuring the tunnel diameter on a two-dimensional (2D) plane and only at one area (most enlarged area or 1- or 2-cm distal from the joint line). 3D CT analysis is a more reliable and accurate evaluation method of tunnel enlargement after ACL reconstruction (Basson et al, 2016 ; Robbrecht et al, 2014 ). Therefore, we evaluated the tibial tunnel enlargement after the ATB ACL reconstruction using 3D CT models.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography (CT) is shown to be more reliable imaging modality for the evaluation of tunnel enlargement than magnetic resonance imaging (MRI) because the sclerotic tunnel margin is clearly visualized (Marchant et al, 2010 ). In addition, multi-planar analysis using three-dimensional (3D) reconstructed CT images enables more accurate evaluation because the tunnel enlargement occurs in multiple directions (Basson et al, 2016 ; Robbrecht et al, 2014 ). We previously evaluated the femoral tunnel enlargement at the tunnel aperture and inside the tunnel and clarified the morphological change at the tunnel footprint after the ATB ACL reconstruction using 3D CT models (Tachibana et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

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Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft

et al. 2017

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BackgroundThree-dimensional (3D) reconstructed computed tomography (CT) is crucial for the reliable and accurate evaluation of tunnel enlargement after anterior cruciate ligament (ACL) reconstruction. The purposes of this study were to evaluate the tibial tunnel enlargement at the tunnel aperture and inside the tunnel and to clarify the morphological change at the tunnel footprint 1 year after the anatomic triple-bundle (ATB) ACL reconstruction using 3D CT models.MethodsEighteen patients with unilateral ACL rupture were evaluated. The ATB ACL reconstruction with a semitendinosus tendon autograft was performed. 3D computer models of the tibia and the three tibial tunnels were reconstructed from CT data obtained 3 weeks and 1 year after surgery. The cross-sectional areas (CSAs) of the two anterior and the one posterior tunnels were measured at the tunnel aperture and 5 and 10 mm distal from the aperture and compared between the two periods. The locations of the center and the anterior, posterior, medial, and lateral edges of each tunnel footprint were also measured and compared between the two periods.ResultsThe CSA of the posterior tunnel was significantly enlarged at the aperture by 40.4%, whereas that of the anterior tunnels did not change significantly, although the enlargement rate was 6.1%. On the other hand, the CSA was significantly reduced at 10 mm distal from the aperture in the anterior tunnels. The enlargement rate in the posterior tunnel was significantly greater than that in the anterior tunnels at the aperture. The center of the posterior tunnel footprint significantly shifted postero-laterally. The anterior and posterior edges of the posterior tunnel footprint demonstrated a significant posterior shift, while the lateral edge significantly shifted laterally. There was no significant shift of the center or all the edges of the anterior tunnels footprint.ConclusionsThe posterior tibial tunnel was significantly enlarged at the aperture by 40% with the morphological change in the postero-lateral direction reflected by the ACL fiber orientation 1 year after the ATB ACL reconstruction. The proper tibial tunnel location in the ACL reconstruction should be determined considering the tunnel enlargement in postero-lateral direction after surgery.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft

et al. 2017

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“…В работе B. Basson с соавторами среднее расширение бедренного канала при ис-пользовании подвешивающего фиксатора пуго-вицы Ziploop (Biomet) составило 49,32±0,52%. Однако авторы использовали оценку расши-рения каналов по данным компьютерной то-мографии (КТ) [7]. В исследовании A. Weber с соавторами измерение диаметра костных ка-налов выполняли по данным МРТ в коронарной и сагиттальной плоскостях на 3 уровнях.…”

Section: результатыunclassified

Combined Femoral Fixation Tecnique in Hamstring Tendon Anterior Cruciate Ligament Reconstruction: Asessment of Tunnel Widening

Korolev

Магнитская

Рязанцев

et al. 2017

Traumatology and Orthopedics of Russia

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Purpose – to assess the influence of combined femoral fixation technique during arthroscopic ACL reconstruction on the femoral tunnel widening at long term follow-up.Material and methods. 99 patients with primary hamstring tendon (HT) ACL reconstruction performed in 2007-2008 were analyzed. In the study group (42 patients) on the femoral side a combined cortical suspension (Endobutton CL, Smith Nephew) and transverse (Rigid Fix, Depuy Mitek) fixation of graft was used. In control group, isolated cortical suspension fixation (Endobutton CL, Smith Nephew) was used. On the tibial side for graft fixation a biodegradable screw (Biointrafix, DePuy Mitek) was used in all cases. Tunnel widening was calculated in percentage against primary tunnel diameter created during the surgery. MRI data were exported to eFilm (Merge Healthcare software), measurement of femoral tunnel diameters was performed on T1 sequences in coronal and sagittal planes on three different levels.Results. The mean age at the last follow up in the study group was 38.9±1.4, in control group – 38,6±1,08. The median time from surgery to follow up was 9 years and 4 months in the study group and 8 years 7 months in the controls. The incidence of graft failure in the study group was reported as 14.3%, while in the control group as 17,5%. The median femoral tunnel widening was larger in the control group at the joint aperture and midsection levels both in coronal and sagittal plane, although there was no statistically significant differences (p0,05).Conclusion. The combination of cortical suspension and transverse HT femoral graft fixation technique is likely to reduce tunnel enlargement at the long term follow-up. However further research and larger sample groups are required.

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“…The XtendoButton™ can be fitted on the EndoButton™ system when the femoral socket is drilled too deep, thus opening the femoral tunnel. 24,25 Tunnel expansion and widening appear most frequently in the use of autogenous hamstring tendon versus autogenous patellar tendon use. MRI studies have shown that tunnel expansion is due to the accumulation of periligamentous tissue around the graft.…”

Section: Complicationsmentioning

confidence: 99%

The ACL Fixation

Codorean

Tanase

Predescu

et al. 2016

Journal of Interdisciplinary Medicine

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The effect of femoral tunnel widening on one-year clinical outcome after anterior cruciate ligament reconstruction using ZipLoop® technology for fixation in the cortical bone of the femur

Cited by 18 publications

References 24 publications

Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft

Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft

Combined Femoral Fixation Tecnique in Hamstring Tendon Anterior Cruciate Ligament Reconstruction: Asessment of Tunnel Widening

The ACL Fixation

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