2010
DOI: 10.1007/s00167-010-1046-z
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Femoral tunnel enlargement after anatomic ACL reconstruction: a biological problem?

Abstract: Tunnel enlargement after anterior cruciate ligament (ACL) reconstruction may compromise revision surgery. The cause of this tunnel enlargement is not yet fully understood, but it is thought to be multifactorial, with biomechanical and biological factors playing a role. Tunnel enlargement has been described particularly in patients who underwent ACL reconstruction with hamstring tendons with extracortical fixation devices. The purpose of our study was to evaluate prospectively with magnetic resonance imaging (M… Show more

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Cited by 85 publications
(109 citation statements)
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“…Tunnel widening of more than 1.5£ the initial tunnel was less observed in the aperture Wxation of BPTB (29%) than with the non-aperture Wxation of the hamstrings (47%) after initial surgery. Silva et al [48] conclude that "tunnel enlargement" is more often of biological than of mechanical origin. The patients in the present study whose drill holes were not evaluable radiographically at the Wrst follow-up could be readily assessed at the second follow-up because of the sclerosis that had evolved in the meantime.…”
Section: Discussionmentioning
confidence: 98%
“…Tunnel widening of more than 1.5£ the initial tunnel was less observed in the aperture Wxation of BPTB (29%) than with the non-aperture Wxation of the hamstrings (47%) after initial surgery. Silva et al [48] conclude that "tunnel enlargement" is more often of biological than of mechanical origin. The patients in the present study whose drill holes were not evaluable radiographically at the Wrst follow-up could be readily assessed at the second follow-up because of the sclerosis that had evolved in the meantime.…”
Section: Discussionmentioning
confidence: 98%
“…The widest tunnel diameter was noted at different levels in relation to the joint 3,9,10,17,18,20,22,38,44 . The percentages of the absolute values to the original drill bit size were calculated 3,9,10,17,18,20,22,38,44 . Susceptibility artifacts, caused by metallic implants such as buttons, screws or pins, which are commonly used in ACL surgery, can limit 17 .…”
Section: Discussionmentioning
confidence: 94%
“…The percentages of the absolute values to the original drill bit size were calculated 1, 7, 8, 15, 26, 31-33, 37, 39, 41-43, 46, 47 . In contrast to CT, MRI promises not only structural information on the tunnels, but also allows evaluation of the ACL graft itself 3,9,10,17,18,20,22,38,44 . Major drawback is the limited assessment of osseous structures in MRI.…”
Section: Discussionmentioning
confidence: 99%
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