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J Knee Surg 2020; 33(05): 445-451
DOI: 10.1055/s-0039-1681064
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Length of the Tendon within the Tibial Tunnel Affects Tibial Tunnel Widening following Anatomic Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft

Shuji Taketomi
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroshi Inui
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Ryota Yamagami
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Kohei Kawaguchi
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Keiu Nakazato
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Kenichi Kono
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Manabu Kawata
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Takumi Nakagawa
2   Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
,
Sakae Tanaka
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

09 July 2018

27 December 2018

Publication Date:
05 March 2019 (online)

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Abstract

The purpose of this study was to retrospectively investigate the effects of variations in the length of the tendon within the tibial tunnel on tunnel widening (TW) following anatomical anterior cruciate ligament (ACL) reconstruction using a bone–patellar tendon–bone (BTB) graft. In total, 68 patients who underwent isolated ACL reconstructions using BTB grafts were included in this study. The patients were divided into two groups according to the length of the tendon within the tibial tunnel: group S (n = 30; tendon length, < 10 mm) and group L (n = 38; tendon length, ≥ 10 mm). Tunnel aperture area was measured using three-dimensional computed tomography (3D CT) at 1 week and 1 year postoperatively, and tibial TW (%) was calculated. The correlation coefficient between the length of the tendon within the tibial tunnel and tibial TW was also calculated. Clinical assessment was performed 1 year postoperatively, corresponding to the period of CT assessment, which involved the evaluation of the Lysholm's score, measurement of anterior knee stability using a KneeLax3 arthrometer, and the pivot-shift test. A weak positive correlation was observed between the length of the tendon within the tibial tunnel and tibial TW (r = 0.270, p = 0.026). Mean tibial tunnel aperture area increased by 19.3 ± 17.4% and 35.8 ± 25.4% in the groups S and L, respectively. TW in the group L was significantly greater than that in the group S (p = 0.004). No significant difference was observed between the two groups in any clinical outcomes. In conclusion, a longer tendinous portion within the tibial tunnel resulted in a greater tibial TW following anatomical ACL reconstructions using a BTB graft.

Keywords

tunnel widening - tibial tunnel - bone–patellar tendon–bone graft - anterior cruciate ligament
 

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