Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 5-Year Follow-Up

Abstract

To radiographically assess the tibial tunnel up to 5years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws. Fifty-one patients underwent anatomic single-bundle ACL reconstruction with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up. The mean follow-up period was 65months (±3.9months), with a minimum of 59months. The width of the tibial tunnel on the anteroposterior view was 9.4mm (±1.4mm) in the early postoperative period and 9.2mm (±1.5mm) at 5years (P= .64). The corresponding widths on the lateral view were 9.6mm (±1.5mm) in the early postoperative period and 9.0mm (±1.4mm) at 5years (P= .014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment. In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws. Level II, prospective study.