Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study
<i>Background and Objectives</i>: Tunnel enlargement (TE) is a widely reported phenomenon after anterior cruciate ligament reconstruction (ACLR). Given the paucity of knowledge in the literature, it remains unclear whether screw position in the tunnel affects TE. This retrospective cohor...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/59/2/390 |
| _version_ | 1797619379500744704 |
|---|---|
| author | Yangang Kong Lifeng Yin Hua Zhang Wenlong Yan Jiaxing Chen Aiguo Zhou Jian Zhang |
| author_facet | Yangang Kong Lifeng Yin Hua Zhang Wenlong Yan Jiaxing Chen Aiguo Zhou Jian Zhang |
| author_sort | Yangang Kong |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Tunnel enlargement (TE) is a widely reported phenomenon after anterior cruciate ligament reconstruction (ACLR). Given the paucity of knowledge in the literature, it remains unclear whether screw position in the tunnel affects TE. This retrospective cohort study evaluated differences in postoperative tunnel enlargement rates (TER) and clinical results between anterior and posterior tibial interference screw insertion during single-bundle ACLR using autologous hamstring grafts. <i>Materials and Methods</i>: A group of consecutive patients that underwent primary arthroscopic single-bundle ACLR in our hospital were screened and divided into two groups based on the position of the tibial interference screw (determined by Computer Tomography within 3 days after surgery): anterior screw position group (A) and posterior screw position group (B). The bone tunnel size was measured using magnetic resonance imaging (MRI) performed 1 year after surgery. International Knee Documentation Committee (IKDC) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were used for clinical results 1 year postoperatively. <i>Results</i>: 87 patients were included. The TER of Group A is higher than that of Group B (43.17% vs. 33.80%, <i>p</i> = 0.024). Group A showed a significant increase (12.1%) in enlargement rates at the joint line level than group B (43.77% vs. 31.67%, <i>p</i> = 0.004). Moreover, KOOS and IKDC scores improved in both groups. There were no significant differences in clinical outcomes between the two groups. <i>Conclusions</i>: One year after ACLR, patients with posterior screw showed significantly lower TE than patients with anterior screw. However, the position of screw did not lead to differences in clinical results over our follow-up period. Posterior screw position in the tibial tunnel maybe a better choice in terms of reducing TE. Whether the different screw positions affect the long-term TE and long-term clinical outcomes needs to be confirmed by further studies. |
| first_indexed | 2024-03-11T08:27:23Z |
| format | Article |
| id | doaj.art-79a998c39a074918bce3a6a8706579b2 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T08:27:23Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-79a998c39a074918bce3a6a8706579b22023-11-16T22:01:08ZengMDPI AGMedicina1010-660X1648-91442023-02-0159239010.3390/medicina59020390Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective StudyYangang Kong0Lifeng Yin1Hua Zhang2Wenlong Yan3Jiaxing Chen4Aiguo Zhou5Jian Zhang6Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, ChinaDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China<i>Background and Objectives</i>: Tunnel enlargement (TE) is a widely reported phenomenon after anterior cruciate ligament reconstruction (ACLR). Given the paucity of knowledge in the literature, it remains unclear whether screw position in the tunnel affects TE. This retrospective cohort study evaluated differences in postoperative tunnel enlargement rates (TER) and clinical results between anterior and posterior tibial interference screw insertion during single-bundle ACLR using autologous hamstring grafts. <i>Materials and Methods</i>: A group of consecutive patients that underwent primary arthroscopic single-bundle ACLR in our hospital were screened and divided into two groups based on the position of the tibial interference screw (determined by Computer Tomography within 3 days after surgery): anterior screw position group (A) and posterior screw position group (B). The bone tunnel size was measured using magnetic resonance imaging (MRI) performed 1 year after surgery. International Knee Documentation Committee (IKDC) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were used for clinical results 1 year postoperatively. <i>Results</i>: 87 patients were included. The TER of Group A is higher than that of Group B (43.17% vs. 33.80%, <i>p</i> = 0.024). Group A showed a significant increase (12.1%) in enlargement rates at the joint line level than group B (43.77% vs. 31.67%, <i>p</i> = 0.004). Moreover, KOOS and IKDC scores improved in both groups. There were no significant differences in clinical outcomes between the two groups. <i>Conclusions</i>: One year after ACLR, patients with posterior screw showed significantly lower TE than patients with anterior screw. However, the position of screw did not lead to differences in clinical results over our follow-up period. Posterior screw position in the tibial tunnel maybe a better choice in terms of reducing TE. Whether the different screw positions affect the long-term TE and long-term clinical outcomes needs to be confirmed by further studies.https://www.mdpi.com/1648-9144/59/2/390ACL reconstructioninterference screwtibial tunnel enlargementscrew positionMRI |
| spellingShingle | Yangang Kong Lifeng Yin Hua Zhang Wenlong Yan Jiaxing Chen Aiguo Zhou Jian Zhang Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study Medicina ACL reconstruction interference screw tibial tunnel enlargement screw position MRI |
| title | Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study |
| title_full | Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study |
| title_fullStr | Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study |
| title_full_unstemmed | Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study |
| title_short | Anterior Screw Insertion Results in Greater Tibial Tunnel Enlargement Rates after Single-Bundle Anterior Cruciate Ligament Reconstruction than Posterior Insertion: A Retrospective Study |
| title_sort | anterior screw insertion results in greater tibial tunnel enlargement rates after single bundle anterior cruciate ligament reconstruction than posterior insertion a retrospective study |
| topic | ACL reconstruction interference screw tibial tunnel enlargement screw position MRI |
| url | https://www.mdpi.com/1648-9144/59/2/390 |
| work_keys_str_mv | AT yangangkong anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT lifengyin anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT huazhang anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT wenlongyan anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT jiaxingchen anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT aiguozhou anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy AT jianzhang anteriorscrewinsertionresultsingreatertibialtunnelenlargementratesaftersinglebundleanteriorcruciateligamentreconstructionthanposteriorinsertionaretrospectivestudy |