Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction - a CT scan analysis three months postoperativelyReportar como inadecuado




Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction - a CT scan analysis three months postoperatively - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Musculoskeletal Disorders

, 16:200

First Online: 19 August 2015Received: 20 December 2014Accepted: 31 July 2015

Abstract

BackgroundBone tunnel enlargement is a phenomenon present in all anterior cruciate ligament ACL- reconstruction techniques. It was hypothesized that press-fit fixation using a free autograft bone plug reduces the overall tunnel size in the tibial tunnel.

MethodsIn a prospective cohort study twelve patients who underwent primary ACL reconstruction using an autologous quadriceps tendon graft and adding a free bone block for press-fit fixation PF in the tibial tunnel were matched to twelve patients who underwent ACL reconstruction with a hamstring graft and interference screw fixation IF. The diameters of the bone tunnels were analysed by a multiplanar reconstruction technique MPR in a CT scan three months postoperatively. Manual and instrumental laxity Lachman test, Pivot-shift test, Rolimeter and functional outcome scores International Knee Documentation Committee sore, Tegner activity level were measured after one year follow up.

ResultsIn the PF group the mean bone tunnel diameter at the level of the joint entrance was not significantly enlarged. One and two centimeter distal to the bone tunnel diameter was reduced by 15 % p = .001. In the IF group the bone tunnel at the level of the joint entrance was enlarged by 14 % p = .001. One and two centimeter distal to the joint line the IF group showed a widening of the bone tunnel by 21 % p < .001 One and two centimeter below the joint line the bone tunnel was smaller in the PF group when compared to the IF group p < .001. No significant difference for laxity test and functional outcome scores could be shown.

ConclusionThis study demonstrates that press-fit fixation with free autologous bone plugs in the tibial tunnel results in significantly smaller diameter of the tibial tunnel compared to interference screw fixation.

AbbreviationsACLAnterior crucriate ligament

FOVfield of view

ICCIntraclass correlation coefficient

IFinterference screw fixation

IKDCInternational Knee Documentation Committee score

MPRmultiplanar reconstruction

PFpress-fit fixation

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Autor: Ralph Akoto - Jonas Müller-Hübenthal - Maurice Balke - Malte Albers - Bertil Bouillon - Philip Helm - Marc Banerjee - Jü

Fuente: https://link.springer.com/



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