Radiological study of bone tunnel widening following ACL reconstruction and its effect on clinical outcome: A retrospective study

Abstract

BackgroundA common complication of ACL Reconstruction surgery is bone tunnel enlargement. The cause of tunnel widening is due to mechanical and biological factors. AimComprehensive clinical and radiographic assessment of postoperative knees following ACL Reconstruction is critical to understand their correlation. Materials and methodsOur study comprised of 23 individuals between the age of 18 and 45 who visited the sports clinic at a tertiary care hospital and underwent ACL reconstruction. During the follow-up appointment at 1 year postoperatively, clinical and radiological assessments were performed. To estimate tunnel widening, the diameters of the tibial and femoral tunnels were measured at different locations within the tunnel using CT of the operated knee and compared to intraoperative tunnel diameters. The patients were also clinically assessed using Lachman test and scored using the IKDC and Lysholm criteria. The results were compared to preoperative functional knee ratings. ResultsThe tibial and femoral tunnel diameter enlarged significantly (p < 0.05) at their apertures and in the middle of the tunnel after ACL reconstruction. Significant improvement (p < 0.05) was seen in knee laxity from preoperative to post-operative stage for Lachman test. Knee functionality score significantly improved from preoperative to post-operative stage. The current study showed that femoral and tibial tunnel widening had no effect on clinical outcomes. ConclusionThere was no correlation seen between tunnel widening and clinical outcome following ACL reconstruction. However, given the limited sample size of this study, there is further need to investigate these parameters.