Tibial tunnel enlargement after arthroscopic anterior cruciate ligament reconstruction

2002 ◽  
Vol 16 (1) ◽  
pp. 22-25
Author(s):  
M. Majewski ◽  
K. R. Schulte ◽  
C. D. Harner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Enlargement ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Comparison of Three Techniques of Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Graft: Differences in Anterior Tibial Translation and Tunnel Enlargement with Each Technique

2003 ◽  
Vol 31 (2) ◽  
pp. 282-288 ◽  
Author(s):  
Hironori Otsuka ◽  
Yasuyuki Ishibashi ◽  
Eiichi Tsuda ◽  
Kazuhiro Sasaki ◽  
Satoshi Toh
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Enlargement ◽  
Cruciate Ligament Reconstruction ◽  
Fixation Group ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

Background: Anatomic fixation of the graft in anterior cruciate ligament reconstruction has improved stability of the reconstructed knee joint in experimental studies. Hypothesis: Anatomic fixation of the bone-patellar tendon-bone autograft will reduce tunnel enlargement and improve clinical results. Study Design: Prospective cohort study. Methods: Sixty patients were randomly divided into three groups: a nonanatomic fixation group (traditional single-incision reconstruction), an anatomic fixation group (reconstruction in which a bone plug was grafted into the tibial tunnel), and an anatomic fixation group with all-inside reconstruction. Stability of the knee joint was examined with a KT-1000 arthrometer at 2, 4, 6, 12, and 24 months after surgery. At 12 months, anteroposterior and lateral radiographs were made to assess tunnel enlargement. Results: Although the magnitude of tibial displacement gradually increased after reconstruction in all three groups, the anatomic fixation group had significantly better stability than the groups undergoing nonanatomic fixation or all-inside anatomic fixation at 4 and 6 months after anterior cruciate ligament reconstruction. However, there was no significant difference between the three groups at 24 months. Regarding the tibial tunnel, residual rates and enlargement of tunnels were different between the reconstruction techniques. The nonanatomic reconstruction group had significantly greater tunnel enlargement. Conclusion: Anatomic fixation of the graft decreased the tunnel enlargement but had no effect on knee stability at 2-year follow-up.

Radiographic and Histologic Analysis of the Tibial Tunnel after Allograft Anterior Cruciate Ligament Reconstruction in Goats

2002 ◽  
Vol 30 (3) ◽  
pp. 368-373 ◽  
Author(s):  
N. Lindsay Harris ◽  
Peter A. Indelicato ◽  
Mark S. Bloomberg ◽  
Keith Meister ◽  
Donna L. Wheeler
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Enlargement ◽  
Cruciate Ligament Reconstruction ◽  
Histologic Analysis ◽  
Anterior Cruciate ◽  
Bone Plug

Background Several problems have been reported with use of allogenic grafts in anterior cruciate ligament reconstruction, including local immune response to allograft tendon within the synovial fluid, delayed maturation and ligamentization, and progressive tibial tunnel enlargement. Hypothesis There is a correlation between the use of allograft and tibial tunnel enlargement. Study Design Controlled laboratory study. Methods Twenty healthy adult female goats underwent allograft anterior cruciate ligament reconstruction and were followed with serial radiographs at 6-week intervals. Animals were randomly chosen for sacrifice between 18 and 36 weeks for histologic assessment. Results Significant radiographic increases in tunnel size were noted within the first 6 weeks of healing and remained up to 36 weeks with no further remodeling noted. Histologic analysis showed progressive ligamentization of the allografts with tendon-to-tunnel wall biologic fixation with dense connective tissue. Remodeling and incorporation of the bone plug was seen in all cases. The allograft tendon underwent early fibrous attachment within the tunnel and remodeled toward ligament histologic structure. Remodeling and incorporation of the bone plug was seen by 18 weeks. Conclusion Tibial tunnel enlargement, consistent with that seen in humans after allograft anterior cruciate ligament reconstruction, did not appear to affect the ultimate incorporation of the allograft on a histologic level.

scholarly journals Extra-articular migration of PEEK interference screw after anterior cruciate ligament reconstruction: a report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Hua Fang ◽  
Ming Li ◽  
Yun-Feng Zhang ◽  
Hua Liu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Interference Screw ◽  
Negative Effects ◽  
Cruciate Ligament Reconstruction ◽  
Screw Extrusion ◽  
Anterior Cruciate

Abstract Background The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, “bioresorbable,” or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. Case report An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. Conclusions The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.

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