Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

• Published in: Knee Surgery and Related Research, 30(4) Vol. 30; no. 4; pp. 341 - 347
• Main Authors: Sundararajan, Silvampatti Ramasamy, Sambandam, Balaji, Singh, Ajay, Rajagopalakrishnan, Ramakanth, Rajasekaran, Shanmuganathan
• Format: Journal Article
• Language: English
• Published: England Korean Knee Society 01-12-2018; 대한슬관절학회
• Subjects: Original; 정형외과학; Knee; Reconstruction; Arthroscopy; Tunnel; Widening; Anterior cruciate ligament
• ISSN: 2234-0726; 1225-1623; 2234-2451
• DOI: 10.5792/ksrr.18.005

Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening.
Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up.
The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups.
The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices.
Level 3, Retrospective Cohort.