Magnetic resonance imaging in evaluation of tunnel diameters prior to revision ACL reconstruction: a comparison to computed tomography

Drews, B.; Merz, Cornelia; Huth, Jochen; Gulkin, Daniel; Guelke, Joachim; Gebhard, Florian; Mauch, Frieder

doi:10.1007/s00256-017-2704-8

Cited by 5 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Measurements of both tunnel expansion and graft maturation were conducted via quantitative image analysis of MRI scans performed at six months after surgery for both groups. Measurements of the tibial and femoral tunnel widening diameters were conducted using an established approach [ 19 ]. The femoral tunnel and tibial tunnels were measured at four points: the aperture, midpoint, tunnel end, and at the greatest tunnel diameter by taking the measurement of the diameter perpendicular to the tunnel—see Figure 2 A–F.…”

Section: Methodsmentioning

confidence: 99%

Effects of Platelet-Rich Osteoconductive–Osteoinductive Allograft Compound on Tunnel Widening of ACL Reconstruction: A Randomized Blind Analysis Study

2022

View full text Add to dashboard Cite

The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. Bone tunnel widening is a known phenomenon after soft-tissue ACL reconstruction and etiology and the clinical relevance has not been fully elucidated. Osteoconductive compounds are biomaterials providing an appropriate scaffold for bone formation such as a demineralized bone matrix. Osteoinductive materials contain growth factors stimulating bone lineage cells and bone growth. A possible application of osteoinductive/osteoconductive (OIC) material is in ACL surgery. We hypothesized that OIC placed in ACL bone tunnels: (1) reduces tunnel widening, (2) improves graft maturation, and (3) reduces tunnel ganglion cyst formation. To test this hypothesis, this study evaluated the osteogenic effects of demineralized bone matrix (DBM) and platelet-rich plasma (PRP) on tunnel widening, graft maturation, and ganglion cyst formation. This was a randomized controlled clinical trial pilot study. A total of 26 patients that elected to have ACL reconstruction surgery were randomized between the OIC and control group. Measurements of tunnel expansion and graft-tunnel incorporation were conducted via the quantitative image analysis of MRI scans performed at six months after surgery for both groups. No patients had adverse post-operative reactions or infections. The use of OIC significantly reduced tunnel widening (p < 0.05) and improved graft maturation (p < 0.05). Patients treated with OIC had a significantly lower prevalence of ganglion cyst compared to the control group (p < 0.05). The use of OIC has measurable effects on the reduction of tunnel widening, improved graft maturation, and decreased size of ganglion cyst after ACL reconstruction. This study explored the utilization of biologics to minimize bone tunnel widening in ACL reconstruction surgery.

show abstract

Section: Methodsmentioning

confidence: 99%

Effects of Platelet-Rich Osteoconductive–Osteoinductive Allograft Compound on Tunnel Widening of ACL Reconstruction: A Randomized Blind Analysis Study

2022

View full text Add to dashboard Cite

show abstract

“…Measurements of both tunnel expansion and graft maturation were conducted via quantitative image analysis of MRI scans performed at six months after surgery for both groups. Measurements of the tibial and femoral tunnel widening diameters were conducted using an established approach [6]. The femoral tunnel and tibial tunnels were measured at four points: the aperture, midpoint, tunnel end, and at the greatest tunnel diameter by taking the measurement of the diameter perpendicular to the tunnel, see Figure 2A-F.…”

Section: Methodsmentioning

confidence: 99%

Tunnel Widening of Acl Reconstruction Augmented by an Platelet Rich Osteoconductive-Osteoinductive Allograft Compound: A Randomized Blind-Analysis Pilot Study

Solomon

Hommen

Travascio

2022

Preprint

View full text Add to dashboard Cite

Background: The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. Bone tunnel widening is a known phenomenon after soft-tissue ACL reconstruction and etiology and clinical relevance have not been fully elucidated. Osteoconductive compounds are biomaterials providing an appropriate scaffold for bone formation such as demineralized bone matrix. Osteoinductive materials contain growth factors stimulating bone lineage cells and bone growth. A possible application of osteoinductive/osteoconductive (OIC) material is in ACL surgery. Questions/Purposes: We hypothesized that OIC placed in ACL bone tunnels: 1) reduces tunnel widening, 2) improves graft maturation and 3) reduces tunnel ganglion cyst formation. To test this hypothesis, this study evaluated the osteogenic effects of demineralized bone matrix (DBM) and platelet rich plasma (PRP) on tunnel widening, graft maturation, and ganglion cyst formation. Study Design: Randomized controlled clinical trial pilot study. Methods: A total of 26 patients electing ACL reconstruction surgery were randomized between OIC and control group. Measurements of tunnel expansion and graft-tunnel incorporation were conducted via quantitative image analysis of MRI scans performed at six months after surgery for both groups. Results: No patients had adverse post-operative reactions or infections. The use of OIC significantly reduced tunnel widening (p < 0.05) and improved graft maturation (p < 0.05). Patients treated with OIC presented with a significantly lower prevalence of ganglion cyst compared to the control group (p < 0.05). Conclusion: The use of OIC has measurable effects on the reduction of tunnel widening, improved graft maturation and decreased size of ganglion cyst after ACL reconstruction. Clinical Relevance: This study explored the utilization of biologics to minimize bone tunnel widening in ACL reconstruction surgery. Study Design: Randomized controlled clinical trial.

show abstract

“…7 However, 3D MRIs have been reported to have similar accuracy as CT scans with the additional benefits of reducing exposure and potentially eliminating the cost of obtaining a CT scan. 3…”

Section: Video Transcriptmentioning

confidence: 99%

“…7 However, 3D MRIs have been reported to have similar accuracy as CT scans with the additional benefits of reducing exposure and potentially eliminating the cost of obtaining a CT scan. 3 Indications for 2-stage revision ACL reconstruction includes malpositioned bone tunnels that will interfere with revision reconstruction tunnel placement and the presence of tunnel osteolysis, active infection, and arthrofibrosis with loss of motion. 2,7 Bone grafting as the first stage has been shown to improve the success of revision ACL reconstruction.…”

Section: Video Transcriptmentioning

confidence: 99%

Two-Stage Revision ACL Reconstruction with Arthroscopic Tunnel Bone Grafting

Barnes,

Kaeding,

Magnussen

et al. 2023

Video Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Anterior cruciate ligament (ACL) reconstruction is a common orthopedic surgery, and due to the increased number of primary reconstructions being performed, the number of revision ACL reconstructions is also increasing. Indications: Two-stage revision ACL reconstruction has lower failure rates compared to 1-stage and is indicated when significant tunnel expansion has occurred or malpositioned tunnels prohibit an adequate reconstruction. In this presentation, 2-stage revision ACL reconstruction was performed with an arthroscopic bone grafting technique of both the femoral and tibial tunnels secondary to tunnel osteolysis. Technique Description: Standard diagnostic arthroscopy is performed, and any chondral or meniscal pathology is addressed. The remnant ACL graft and all hardware are removed. The tunnels are debrided thoroughly. Using a modified syringe, the tunnels are packed with a mixture of cancellous bone chips and cortical fibers that have been hydrated with whole blood and platelet-rich plasma (PRP). The patient is placed into a brace postoperatively, and a computed tomography (CT) is obtained approximately 4 to 6 months postoperatively to assess for bone healing. Revision ACL reconstruction is performed once indicated with standard rehabilitation and return to play protocol. Results: Both 1-stage and 2-stage revision ACL reconstructions have been demonstrated to have significant improvement in outcomes scores preoperatively to postoperatively. However, 2-stage has lower failure rates compared to single-stage and has a high return to level of play. Discussion/Conclusion: Revision ACL reconstruction is becoming more commonly performed, and 2-stage revision is frequently required due to multiple factors. In this video, we demonstrate bone grafting for revision ACL reconstruction for tunnel osteolysis. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

show abstract

Magnetic resonance imaging in evaluation of tunnel diameters prior to revision ACL reconstruction: a comparison to computed tomography

Cited by 5 publications

References 24 publications

Effects of Platelet-Rich Osteoconductive–Osteoinductive Allograft Compound on Tunnel Widening of ACL Reconstruction: A Randomized Blind Analysis Study

Effects of Platelet-Rich Osteoconductive–Osteoinductive Allograft Compound on Tunnel Widening of ACL Reconstruction: A Randomized Blind Analysis Study

Tunnel Widening of Acl Reconstruction Augmented by an Platelet Rich Osteoconductive-Osteoinductive Allograft Compound: A Randomized Blind-Analysis Pilot Study

Two-Stage Revision ACL Reconstruction with Arthroscopic Tunnel Bone Grafting

Contact Info

Product

Resources

About