Affiliation:
1. Department of Sports Orthopaedics, Osaka Rosai Hospital, Sakai, Japan.
2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
3. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Japan.
Abstract
Background: There exists little information in the relevant literature regarding tunnel enlargement after posterior cruciate ligament (PCL) reconstruction (PCLR). Purpose: To sequentially evaluate tunnel enlargement and radiographic posterior laxity through double-bundle PCLR using autologous hamstring tendon grafts. Study Design: Case series; Level of evidence, 4. Methods: We prospectively analyzed 13 patients who underwent double-bundle PCLR for an isolated PCL injury. Three-dimensional computed tomography images were obtained at 3 weeks, 6 months, and 1 year postoperatively, and the tunnel enlargement was calculated by sequentially comparing the cross-sectional areas of the bone tunnels. We also sequentially measured radiographic posterior laxity. The correlation between the tunnel enlargement ratio and the postoperative increase in posterior laxity was evaluated. Results: The cross-sectional area at the aperture in each tunnel significantly increased from 3 weeks to 6 months ( P < .003), but it did not continue doing so thereafter. The 6-month tunnel enlargement ratios of the femoral anterolateral tunnel, the femoral posteromedial tunnel, the tibial anterolateral tunnel, and the tibial posteromedial tunnel were 31.6% ± 23.5%, 90.3% ± 54.7%, 30.5% ± 26.8%, and 49.6% ± 37.0%, respectively, while the corresponding ratios at 1 year were 28.1% ± 19.8%, 83.1% ± 56.9%, 26.8% ± 32.8%, and 47.6% ± 39.0%, respectively. The posterior laxity was 9.0 ± 4.0 mm, −1.5 ± 2.3 mm, 3.4 ± 2.0 mm, and 3.9 ± 1.9 mm, preoperatively, immediately after surgery, 6 months and 1 year postoperatively, respectively. From the immediate postoperative period, the posterior laxity significantly increased at 6 months postoperatively ( P < .001), but it did not thereafter. The postoperative increase in posterior laxity had a significant positive correlation with the anterolateral tunnel enlargement ratio in both femoral and tibial tunnels at 6 months (ρ = 0.571-0.699; P = .011-.041) and 1 year (ρ = 0.582-0.615; P = .033-.037). Conclusion: Tunnel enlargement after PCLR mainly occurred within 6 months, with no progression thereafter. The anterolateral tunnel enlargement positively correlated with postoperative increase in posterior laxity.
Subject
Orthopedics and Sports Medicine
Cited by
3 articles.
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