Three-dimensional reconstruction with dual-source computed tomography for evaluating graft deformation and bone tunnel position following reconstruction of the anterior cruciate ligament.

Abstract

Considering the limitations of MRI and X-ray and few studies on the use of dual-source computed tomography (DSCT) in anterior cruciate ligament (ACL) reconstruction are limited, this study explored the clinical application of DSCT for three-dimensional reconstruction of graft deformation and bone tunnel position images following ACL reconstruction. The data of 123 patients who underwent single-bundle ACL reconstruction under arthroscopy from January 2017 to October 2021 were retrieved. Two weeks after surgery, DSCT was used to assess graft deformation and tunnel widening. Based on the positions of ACL graft deformation and bone tunnel, the patients were divided into a collision group (n=35), posterior group (n=37) and satisfactory group (n=51). The groups were compared in terms of the relative position of the central point of the femoral tunnel (FX, FY) and tibial tunnel (TX, TY), the straight-line distances of the grafts (L), the sagittal plane angle (∠α), and the coronal plane angle (∠β) between the two bone tunnels. Tx, Ty, ∠α and ∠β were significantly different among the three groups, while no difference in Fx, Fy and L were observed. Tx, Ty and ∠α were identified as independent risk factors for collisions between the graft and intercondylar notch. Ty and ∠α were independent risk factors for posterior deviation of tibial tunnel position. DSCT demonstrated promising clinical applicability to evaluate graft deformation and bone tunnel position after reconstruction of ACL and could guide preoperative positioning and postoperative evaluation.