Abstract
Purpose: The purpose was to determine the impact of the size of bone bruises (BBs) on bone tunnel enlargement (BTE) occurrence. Materials and methods: Twenty-four (24) patients who underwent anterior cruciate ligament reconstruction (ACLR) were included in this retrospective study. The measurements of BBs based on the initial MRI scan, bone tunnel size based on the control MRI scan, and the spatial determination of BB in relation to the bone tunnel location were evaluated. To analyze the relationship between BBs and BTE in homogeneous groups regarding the time from injury to ACLR (t(I-S)), the largest subgroup B (n = 15), in which t(I-S) was 31 to 60 days, was isolated for further investigation. Results: Based on subgroup B, a weak correlation (r = 0.33) existed between the BB volume and BTE size in the femur and tibia. Considering the relationship between the distance from the BB to the bone tunnel in the femur (f-l) and its enlargement (Δfd), there was a moderate and statistically significant (p < 0.05) negative correlation (r = −0.64). The correlation between those parameters was even stronger (r = −0.77) in subgroup B (time interval between injury and surgery ranged from 31 to 60 days). Conclusions: A retrospective analysis of MRI data in patients after ACL reconstruction surgery showed a relevant association between the distance from the BB to the bone tunnel and BTE in the femur. The relationship was not confirmed in the tibia.
Highlights
Anterior cruciate ligament (ACL) ruptures resulting from an indirect mechanism of injury are associated with sport participation and general military and physical activity
The common surgical procedure, ACL reconstruction (ACLR), has demonstrated good clinical outcomes resulting in the restoration knee stability but is associated with complications, e.g., bone tunnel enlargement (BTE)
The most important finding of this retrospective analysis is that the close proximity of the bone bruises (BBs) to the bone tunnel may be a relevant factor influencing the size of BTE in the femur
Summary
Anterior cruciate ligament (ACL) ruptures resulting from an indirect mechanism of injury are associated with sport participation and general military and physical activity. The cause of BTE remains unclear, and two main types of factors are suspected of being involved—mechanical and biological factors [1,2,3,4,5]. Mechanical factors such as tunnel placement, the number of tunnels, the fixation method, the drilling technique used following bone necrosis, and the aggressiveness of the rehabilitation process may be involved [2,6,7,8,9,10,11,12]. BTE occurrence should always be considered seriously in regard to revision surgeries, as the probability of surgery failure increases in the presence of massive BTE [20,21]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
