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Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction

Backgrounds and objectives: A prevalent concern in anterior cruciate ligament (ACL) reconstruction is postoperative tunnel widening. We hypothesized that employing a curved dilator system (CDS) for femoral tunnel creation can reduce this widening after ACL reconstruction compared to the use of a con...

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Autores principales: Lee, O-Sung, Kim, Joong Il, Han, Seok Hyeon, Lee, Joon Kyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456963/
https://www.ncbi.nlm.nih.gov/pubmed/37629727
http://dx.doi.org/10.3390/medicina59081437
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author Lee, O-Sung
Kim, Joong Il
Han, Seok Hyeon
Lee, Joon Kyu
author_facet Lee, O-Sung
Kim, Joong Il
Han, Seok Hyeon
Lee, Joon Kyu
author_sort Lee, O-Sung
collection PubMed
description Backgrounds and objectives: A prevalent concern in anterior cruciate ligament (ACL) reconstruction is postoperative tunnel widening. We hypothesized that employing a curved dilator system (CDS) for femoral tunnel creation can reduce this widening after ACL reconstruction compared to the use of a conventional rigid reamer. Materials and Methods: A retrospective study was conducted involving 56 patients who underwent primary ACL reconstruction between January 2012 and July 2013. The patients were categorized into two groups: the reamer group (n = 28) and CDS group (n = 28). All participants were followed up for a minimum of 2 years. Clinical assessment included the Lachman test and pivot-shift test, and the Lysholm score and subjective International Knee Documentation Committee scores. Radiographic evaluation covered the tunnel widening rate, represented as the ratio of the tunnel diameter 2 years after surgery to the tunnel diameter immediately after surgery, and the ratio (A/B) of femoral tunnel (A) to tibial tunnel (B) diameters at respective time points. Results: No significant disparities were found between the two groups in terms of clinical outcomes. However, the reamer group exhibited a greater femoral tunnel widening rate compared to the CDS group (reamer group vs. CDS group: 142.7 ± 22.0% vs. 128.0 ± 19.0% on the anteroposterior (AP) radiograph and 140.8 ± 14.2% vs. 122.9 ± 13.4% on the lateral radiograph; all p < 0.05). Two years post-operation, the A/B ratio rose in the reamer group (0.96 ± 0.05→1.00 ± 0.05 on the AP radiograph and 0.94 ± 0.03→1.00 ± 0.0.04 on the lateral radiograph; all p < 0.05), while it decreased in the CDS group (0.99 ± 0.02→0.96 ± 0.05 on the AP radiograph and 0.97 ± 0.03→0.93 ± 0.06 on the lateral radiograph; all p < 0.05). Conclusion: The use of CDS for femoral tunnel creation in primary ACL reconstruction provides a potential advantage by limiting tunnel widening compared to the conventional rigid-reamer approach.
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spelling pubmed-104569632023-08-26 Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction Lee, O-Sung Kim, Joong Il Han, Seok Hyeon Lee, Joon Kyu Medicina (Kaunas) Article Backgrounds and objectives: A prevalent concern in anterior cruciate ligament (ACL) reconstruction is postoperative tunnel widening. We hypothesized that employing a curved dilator system (CDS) for femoral tunnel creation can reduce this widening after ACL reconstruction compared to the use of a conventional rigid reamer. Materials and Methods: A retrospective study was conducted involving 56 patients who underwent primary ACL reconstruction between January 2012 and July 2013. The patients were categorized into two groups: the reamer group (n = 28) and CDS group (n = 28). All participants were followed up for a minimum of 2 years. Clinical assessment included the Lachman test and pivot-shift test, and the Lysholm score and subjective International Knee Documentation Committee scores. Radiographic evaluation covered the tunnel widening rate, represented as the ratio of the tunnel diameter 2 years after surgery to the tunnel diameter immediately after surgery, and the ratio (A/B) of femoral tunnel (A) to tibial tunnel (B) diameters at respective time points. Results: No significant disparities were found between the two groups in terms of clinical outcomes. However, the reamer group exhibited a greater femoral tunnel widening rate compared to the CDS group (reamer group vs. CDS group: 142.7 ± 22.0% vs. 128.0 ± 19.0% on the anteroposterior (AP) radiograph and 140.8 ± 14.2% vs. 122.9 ± 13.4% on the lateral radiograph; all p < 0.05). Two years post-operation, the A/B ratio rose in the reamer group (0.96 ± 0.05→1.00 ± 0.05 on the AP radiograph and 0.94 ± 0.03→1.00 ± 0.0.04 on the lateral radiograph; all p < 0.05), while it decreased in the CDS group (0.99 ± 0.02→0.96 ± 0.05 on the AP radiograph and 0.97 ± 0.03→0.93 ± 0.06 on the lateral radiograph; all p < 0.05). Conclusion: The use of CDS for femoral tunnel creation in primary ACL reconstruction provides a potential advantage by limiting tunnel widening compared to the conventional rigid-reamer approach. MDPI 2023-08-08 /pmc/articles/PMC10456963/ /pubmed/37629727 http://dx.doi.org/10.3390/medicina59081437 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, O-Sung
Kim, Joong Il
Han, Seok Hyeon
Lee, Joon Kyu
Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title_full Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title_fullStr Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title_full_unstemmed Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title_short Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction
title_sort beneficial effect of curved dilator system for femoral tunnel creation in preventing femoral tunnel widening after anterior cruciate ligament reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456963/
https://www.ncbi.nlm.nih.gov/pubmed/37629727
http://dx.doi.org/10.3390/medicina59081437
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