Korean J Radiol.  2015 Dec;16(6):1313-1318. 10.3348/kjr.2015.16.6.1313.

Bone Tunnel Diameter Measured with CT after Anterior Cruciate Ligament Reconstruction Using Double-Bundle Auto-Hamstring Tendons: Clinical Implications

• Yoon SJ
• Yoon YC
• Bae SY
• Wang JH

• KMID: 2344286
• DOI: http://doi.org/10.3348/kjr.2015.16.6.1313

Abstract

OBJECTIVE
To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores.
MATERIALS AND METHODS
Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated.
RESULTS
The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of < 0.001; observer 2, 0.581 mm to 0.707 mm, p value of < 0.001). There was no significant correlation between the diameter at T2 and stability or clinical scores and between the interval change ratio ([T2 - T1] / T1) and stability or clinical scores (corrected p values for all were 1.0). Intraobserver agreement for measurements was excellent (> 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311).
CONCLUSION
Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.

Keyword

Knee; Anterior cruciate ligament; Multidetector computed tomography

MeSH Terms

Adolescent
Adult
Anterior Cruciate Ligament/*radiography/surgery
Anterior Cruciate Ligament Reconstruction
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Tendons/anatomy & histology/*radiography
Tibia/anatomy & histology/radiography
*Tomography, X-Ray Computed
Young Adult

Figure

• 

  Fig. 1 Measurement of bone tunnel diameters with multiplanar reconstruction (MPR) method. With oblique axial (A), oblique coronal (B), and oblique sagittal planes (C) for tibial bone tunnel in anteromedial bundle, true sagittal plane (D) for dedicated tibial bone tunnel was obtained by using MPR. Diameters measured on five points of given planes were recorded. Mean value of five measurements of one bone tunnel represents tunnel's diameter.

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