The correlation of tunnel position, orientation and tunnel enlargement in outside-in single-bundle anterior cruciate ligament reconstruction

Young Won Ko, Seung Jun Rhee, In Woo Kim, Jae Doo Yoo

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Purpose: Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a frequently described phenomenon. The possible etiology is multi-factorial with some mechanical and biological factors. Among those, we intended to determine the relation between the location and orientation of the femoral tunnel and the femoral tunnel enlargement after outside-in single-bundle ACL reconstruction. Materials and Methods: A retrospective study including 42 patients who received single-bundle ACL reconstruction with the outside-in technique was conducted. Femoral and tibial tunnel locations were evaluated with the quadrant method and bird’s-eye view using volume-rendering computed tomography. The angle and diameter of bone tunnel and the degree of tunnel enlargement were evaluated using standard radiographs. Results: The degree of femoral tunnel enlargements were 42% and 36% on the anteroposterior (AP) and lateral radiographs, respectively, and the degree of tibial tunnel enlargements were 22% and 23%, respectively. Shallower location of the femoral tunnel was significantly correlated with greater femoral tunnel enlargement on the AP radiograph (r=0.998, p=0.004) and the lateral radiograph (r=0.72, p=0.005) as was the higher location of the femoral tunnel on the AP radiograph (r=–0.47, p=0.01) and the lateral radiograph (r=–0.36, p=0.009) at 12 months after surgery. Conclusions: This study revealed that more anterior and higher location and more horizontal orientation of the femoral tunnel in coronal plane could result in widening of the femoral tunnel in outside-in single-bundle ACL reconstruction.

Original languageEnglish
Pages (from-to)247-254
Number of pages8
JournalKnee Surgery and Related Research
Volume27
Issue number4
DOIs
StatePublished - Dec 2015

Bibliographical note

Publisher Copyright:
© 2015 KOREAN KNEE SOCIETY.

Keywords

  • Anterior cruciate ligament
  • Knee
  • Outside-in technique
  • Tunnel enlargement

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