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, 30 (4), 341-347

Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

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Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

Silvampatti Ramasamy Sundararajan et al. Knee Surg Relat Res.

Abstract

Purpose: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening.

Materials and methods: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up.

Results: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups.

Conclusions: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices.

Level of evidence: Level 3, Retrospective Cohort.

Keywords: Anterior cruciate ligament; Arthroscopy; Knee; Reconstruction; Tunnel; Widening.

Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Flowchart of the study methodology. ACL: anterior cruciate ligament.
Fig. 2
Fig. 2
(A) Anteroposterior and lateral radiographs of knee showing the sclerosed margin of the widened tunnel. (B) Margins of the tunnel marked on both views. (C) Tunnel widening measured at the widest part of the tunnel on both views.
Fig. 3
Fig. 3
(A) Fixation with a fixed-loop device in the femoral end of the tunnel showing the empty turning space. (B) Fixation with an adjustable-loop device without any turning space.

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