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

BACKGROUND: Three-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...

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Autores principales: Ohori, Tomoki, Mae, Tatsuo, Shino, Konsei, Tachibana, Yuta, Sugamoto, Kazuomi, Yoshikawa, Hideki, Nakata, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602815/
https://www.ncbi.nlm.nih.gov/pubmed/28916912
http://dx.doi.org/10.1186/s40634-017-0104-6
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author Ohori, Tomoki
Mae, Tatsuo
Shino, Konsei
Tachibana, Yuta
Sugamoto, Kazuomi
Yoshikawa, Hideki
Nakata, Ken
author_facet Ohori, Tomoki
Mae, Tatsuo
Shino, Konsei
Tachibana, Yuta
Sugamoto, Kazuomi
Yoshikawa, Hideki
Nakata, Ken
author_sort Ohori, Tomoki
collection PubMed
description BACKGROUND: Three-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. METHODS: Eighteen 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. RESULTS: The 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. CONCLUSIONS: The 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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spelling pubmed-56028152017-09-27 Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft Ohori, Tomoki Mae, Tatsuo Shino, Konsei Tachibana, Yuta Sugamoto, Kazuomi Yoshikawa, Hideki Nakata, Ken J Exp Orthop Research BACKGROUND: Three-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. METHODS: Eighteen 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. RESULTS: The 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. CONCLUSIONS: The 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. Springer Berlin Heidelberg 2017-09-15 /pmc/articles/PMC5602815/ /pubmed/28916912 http://dx.doi.org/10.1186/s40634-017-0104-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Ohori, Tomoki
Mae, Tatsuo
Shino, Konsei
Tachibana, Yuta
Sugamoto, Kazuomi
Yoshikawa, Hideki
Nakata, Ken
Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title_full Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title_fullStr Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title_full_unstemmed Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title_short Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
title_sort morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602815/
https://www.ncbi.nlm.nih.gov/pubmed/28916912
http://dx.doi.org/10.1186/s40634-017-0104-6
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