Effect of bone canal widening after anterior cruciate ligament reconstruction

Abstract

One of the complications after anterior cruciate ligament reconstruction is widening of bone canals after surgery, it can lead to slow integration of the graft with bone, promotion of secondary instability and revision reconstruction of anterior cruciate ligament. In order to fix the graft in the femoral and tibia bones endobuttons and interferent screws are widely used.Objective: to evaluate the widening of bone canals after anterior cruciate ligament reconstruction due to computer tomography.Methods: there were 44 patients, who were divided into: group A (24) — technique «all inside» with fixing of semitendinosus graft with short cortical endobutton in the femur and tibia; group B (20) — fixing of semitendinosus and gracilis graft with interferent screws (transportal technique). The rehabilitation protocol was the same for both groups. The mid term for computer tomography study was 10 months after surgery.Results: in group A the average widening of bone canal diameter in the femur was 15 % in the entrance, 12 % in the middle part as to the primary size. In group B — 10 and 7 % respectively. The diameter of the tibia canal enlarged in average: in group A 19 % in the entrance, 15 % in the middle part; in group B — 15 and 11 % respectively. According to clinical study there was not significant difference between groups.Conclusions: in the group where we used cortical fixators the widening of the canals was larger than in those where we used interferent screws, but the difference was not significant, only 5 % for femoral side and 4 % for tibia canals. X-ray signs of canal widening did not influence on clinical or objective results of anterior cruciate ligament reconstruction.