Significant anterior enlargement of femoral tunnel aperture after hamstring ACL reconstruction, compared to bone–patellar tendon–bone graft
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This study aimed to retrospectively compare the enlargement and migration of the femoral tunnel aperture after anatomic rectangular tunnel anterior cruciate ligament (ACL) reconstruction with a bone–patella tendon–bone (BTB) or hamstring tendon (HT) graft using three-dimensional (3-D) computer models.
Thirty-two patients who underwent ACL reconstruction and postoperative computed tomography (CT) at 3 weeks and 6 months were included in this study. Of these, 20 patients underwent ACL reconstruction with a BTB graft (BTBR group), and the remaining 12 with an HT graft (HTR group). The area of the femoral tunnel aperture was extracted and measured using a 3-D computer model generated from CT images. Changes in the area and migration direction of the femoral tunnel aperture during this period were compared between the two groups.
In the HTR group, the area of the femoral tunnel aperture was significantly increased at 6 months compared to 3 weeks postoperatively (P < 0.05). The average area of the femoral tunnel aperture at 6 months postoperatively was larger by 16.0 ± 12.4% in the BTBR group and 41.9 ± 22.2% in the HTR group, relative to that measured at 3 weeks postoperatively (P < 0.05). The femoral tunnel aperture migrated in the anteroinferior direction in the HTR group, and only in the inferior direction in the BTBR group.
The femoral tunnel aperture in the HTR group was significantly more enlarged and more anteriorly located at 6 months after ACL reconstruction, compared to the BTBR group.
Level of evidence
KeywordsAnterior cruciate ligament reconstruction Femoral tunnel enlargement Three-dimensional computer model Hamstring tendon graft Bone–patella tendon–bone graft
No sources of fundings to declare.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study has been approved by the Osaka Rosai Hospital Ethics committee of Japan Organization of Occupational Health and Safety (ID 20130729-5).
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