Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft
Abstract 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 a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-09-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40634-017-0104-6 |
| _version_ | 1797334786365194240 |
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| author | Tomoki Ohori Tatsuo Mae Konsei Shino Yuta Tachibana Kazuomi Sugamoto Hideki Yoshikawa Ken Nakata |
| author_facet | Tomoki Ohori Tatsuo Mae Konsei Shino Yuta Tachibana Kazuomi Sugamoto Hideki Yoshikawa Ken Nakata |
| author_sort | Tomoki Ohori |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-08T08:27:12Z |
| format | Article |
| id | doaj.art-2f957f969f8140408efd2666e4472b1d |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T08:27:12Z |
| publishDate | 2017-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-2f957f969f8140408efd2666e4472b1d2024-02-02T04:28:45ZengSpringerOpenJournal of Experimental Orthopaedics2197-11532017-09-014111010.1186/s40634-017-0104-6Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graftTomoki Ohori0Tatsuo Mae1Konsei Shino2Yuta Tachibana3Kazuomi Sugamoto4Hideki Yoshikawa5Ken Nakata6Department of Orthopaedic Surgery, Osaka University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineSports Orthopaedic Surgery Center, Yukioka HospitalSports Orthopaedic Surgery Center, Yukioka HospitalDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineAbstract 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.http://link.springer.com/article/10.1186/s40634-017-0104-6Anterior cruciate ligamentAnatomicTunnel enlargementTibiaCross-sectional areaHamstring tendon |
| spellingShingle | Tomoki Ohori Tatsuo Mae Konsei Shino Yuta Tachibana Kazuomi Sugamoto Hideki Yoshikawa Ken Nakata Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft Journal of Experimental Orthopaedics Anterior cruciate ligament Anatomic Tunnel enlargement Tibia Cross-sectional area Hamstring tendon |
| 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 | Anterior cruciate ligament Anatomic Tunnel enlargement Tibia Cross-sectional area Hamstring tendon |
| url | http://link.springer.com/article/10.1186/s40634-017-0104-6 |
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