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Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction

BACKGROUND: There exists little information in the relevant literature regarding tunnel enlargement after posterior cruciate ligament (PCL) reconstruction (PCLR). PURPOSE: To sequentially evaluate tunnel enlargement and radiographic posterior laxity through double-bundle PCLR using autologous hamstr...

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Autores principales: Tachibana, Yuta, Tanaka, Yoshinari, Kinugasa, Kazutaka, Mae, Tatsuo, Horibe, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869171/
https://www.ncbi.nlm.nih.gov/pubmed/33614798
http://dx.doi.org/10.1177/2325967120977834
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author Tachibana, Yuta
Tanaka, Yoshinari
Kinugasa, Kazutaka
Mae, Tatsuo
Horibe, Shuji
author_facet Tachibana, Yuta
Tanaka, Yoshinari
Kinugasa, Kazutaka
Mae, Tatsuo
Horibe, Shuji
author_sort Tachibana, Yuta
collection PubMed
description BACKGROUND: There exists little information in the relevant literature regarding tunnel enlargement after posterior cruciate ligament (PCL) reconstruction (PCLR). PURPOSE: To sequentially evaluate tunnel enlargement and radiographic posterior laxity through double-bundle PCLR using autologous hamstring tendon grafts. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We prospectively analyzed 13 patients who underwent double-bundle PCLR for an isolated PCL injury. Three-dimensional computed tomography images were obtained at 3 weeks, 6 months, and 1 year postoperatively, and the tunnel enlargement was calculated by sequentially comparing the cross-sectional areas of the bone tunnels. We also sequentially measured radiographic posterior laxity. The correlation between the tunnel enlargement ratio and the postoperative increase in posterior laxity was evaluated. RESULTS: The cross-sectional area at the aperture in each tunnel significantly increased from 3 weeks to 6 months (P < .003), but it did not continue doing so thereafter. The 6-month tunnel enlargement ratios of the femoral anterolateral tunnel, the femoral posteromedial tunnel, the tibial anterolateral tunnel, and the tibial posteromedial tunnel were 31.6% ± 23.5%, 90.3% ± 54.7%, 30.5% ± 26.8%, and 49.6% ± 37.0%, respectively, while the corresponding ratios at 1 year were 28.1% ± 19.8%, 83.1% ± 56.9%, 26.8% ± 32.8%, and 47.6% ± 39.0%, respectively. The posterior laxity was 9.0 ± 4.0 mm, −1.5 ± 2.3 mm, 3.4 ± 2.0 mm, and 3.9 ± 1.9 mm, preoperatively, immediately after surgery, 6 months and 1 year postoperatively, respectively. From the immediate postoperative period, the posterior laxity significantly increased at 6 months postoperatively (P < .001), but it did not thereafter. The postoperative increase in posterior laxity had a significant positive correlation with the anterolateral tunnel enlargement ratio in both femoral and tibial tunnels at 6 months (ρ = 0.571-0.699; P = .011-.041) and 1 year (ρ = 0.582-0.615; P = .033-.037). CONCLUSION: Tunnel enlargement after PCLR mainly occurred within 6 months, with no progression thereafter. The anterolateral tunnel enlargement positively correlated with postoperative increase in posterior laxity.
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spelling pubmed-78691712021-02-19 Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction Tachibana, Yuta Tanaka, Yoshinari Kinugasa, Kazutaka Mae, Tatsuo Horibe, Shuji Orthop J Sports Med Article BACKGROUND: There exists little information in the relevant literature regarding tunnel enlargement after posterior cruciate ligament (PCL) reconstruction (PCLR). PURPOSE: To sequentially evaluate tunnel enlargement and radiographic posterior laxity through double-bundle PCLR using autologous hamstring tendon grafts. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We prospectively analyzed 13 patients who underwent double-bundle PCLR for an isolated PCL injury. Three-dimensional computed tomography images were obtained at 3 weeks, 6 months, and 1 year postoperatively, and the tunnel enlargement was calculated by sequentially comparing the cross-sectional areas of the bone tunnels. We also sequentially measured radiographic posterior laxity. The correlation between the tunnel enlargement ratio and the postoperative increase in posterior laxity was evaluated. RESULTS: The cross-sectional area at the aperture in each tunnel significantly increased from 3 weeks to 6 months (P < .003), but it did not continue doing so thereafter. The 6-month tunnel enlargement ratios of the femoral anterolateral tunnel, the femoral posteromedial tunnel, the tibial anterolateral tunnel, and the tibial posteromedial tunnel were 31.6% ± 23.5%, 90.3% ± 54.7%, 30.5% ± 26.8%, and 49.6% ± 37.0%, respectively, while the corresponding ratios at 1 year were 28.1% ± 19.8%, 83.1% ± 56.9%, 26.8% ± 32.8%, and 47.6% ± 39.0%, respectively. The posterior laxity was 9.0 ± 4.0 mm, −1.5 ± 2.3 mm, 3.4 ± 2.0 mm, and 3.9 ± 1.9 mm, preoperatively, immediately after surgery, 6 months and 1 year postoperatively, respectively. From the immediate postoperative period, the posterior laxity significantly increased at 6 months postoperatively (P < .001), but it did not thereafter. The postoperative increase in posterior laxity had a significant positive correlation with the anterolateral tunnel enlargement ratio in both femoral and tibial tunnels at 6 months (ρ = 0.571-0.699; P = .011-.041) and 1 year (ρ = 0.582-0.615; P = .033-.037). CONCLUSION: Tunnel enlargement after PCLR mainly occurred within 6 months, with no progression thereafter. The anterolateral tunnel enlargement positively correlated with postoperative increase in posterior laxity. SAGE Publications 2021-01-29 /pmc/articles/PMC7869171/ /pubmed/33614798 http://dx.doi.org/10.1177/2325967120977834 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Tachibana, Yuta
Tanaka, Yoshinari
Kinugasa, Kazutaka
Mae, Tatsuo
Horibe, Shuji
Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title_full Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title_fullStr Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title_full_unstemmed Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title_short Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
title_sort tunnel enlargement correlates with postoperative posterior laxity after double-bundle posterior cruciate ligament reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869171/
https://www.ncbi.nlm.nih.gov/pubmed/33614798
http://dx.doi.org/10.1177/2325967120977834
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