Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 22, Issue 10 , Pages 1107-1112 , October 2006

Tunnel Expansion After Anterior Cruciate Ligament Reconstruction With Autogenous Hamstrings: A Comparison of the Medial Portal and Transtibial Techniques

  • Anikar Chhabra, M.D.

      Affiliations

    • Canyon Orthopaedics Division for Sports Medicine, Phoenix, Arizona
    • ,
  • Alex J. Kline, M.D.

      Affiliations

    • Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
    • ,
  • Kathy M. Nilles, B.S.

      Affiliations

    • Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
    • ,
  • Christopher D. Harner, M.D.

      Affiliations

    • Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
    • Corresponding Author InformationAddress correspondence and reprint requests to Christopher D. Harner, M.D., University of Pittsburgh Medical Center, UPMC Sports Performance Complex, 3200 South Water St, Pittsburgh, PA 15203, U.S.A.

References 

  1. Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: Bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. J Bone Joint Surg Am. 2004;86:2143–2155
  2. Barber AF, Spurill B, Sheluga M. The effect of outlet fixation on tunnel widening. Arthroscopy. 2003;19:485–492
  3. Buck DC, Simonian PT, Larson RV, Borrow J, Nathanson DA. Timeline of tibial tunnel expansion after single-incision hamstring anterior cruciate ligament reconstruction. Arthroscopy. 2004;20:34–36
  4. Buelow JU, Siebold R, Ellermann A. A prospective evaluation of tunnel enlargement in anterior cruciate ligament reconstruction with hamstrings: Extracortical versus anatomical fixation. Knee Surg Sports Traumatol Arthrosc. 2002;10:80–85
  5. Clatworthy MG, Annear P, Bulow JU, Bartlett RJ. Tunnel widening in anterior cruciate ligament reconstruction: A prospective evaluation of hamstring and patella tendon grafts. Knee Surg Sports Traumatol Arthrosc. 1999;7:138–145
  6. Dyer CR, Elrod BF. Tibial and femoral bone tunnel enlargement following allograft replacement of the anterior cruciate ligament. Arthroscopy. 1995;11:353–354
  7. Fahey M, Indelicato PA. Bone tunnel enlargement after anterior cruciate ligament replacement. Am J Sports Med. 1994;22:410–414
  8. Fink C, Zapp M, Benedetto KP, Hackl W, Hoser C, Rieger M. Tibial tunnel enlargement following anterior cruciate ligament reconstruction with patellar tendon autograft. Arthroscopy. 2001;17:138–143
  9. Hantes ME, Mastrokalos DS, Yu J, Paessler HH. The effect of early motion on tibial tunnel widening after anterior cruciate ligament replacement using hamstring tendon grafts. Arthroscopy. 2004;20:572–580
  10. Hersekli MA, Akpinar S, Ozalay M, et al. Tunnel enlargement after arthroscopic anterior cruciate ligament reconstruction: Comparison of bone-patellar tendon-bone and hamstring autografts. Adv Ther. 2004;21:123–131
  11. Hogervorst T, van der Hart CP, Pels Rijcken TH, Taconis WK. Abnormal bone scans of the tibial tunnel 2 years after patella ligament anterior cruciate ligament reconstruction: Correlation with tunnel enlargement and tibial graft length. Knee Surg Sports Traumatol Arthrosc. 2000;8:322–328
  12. Hoher J, Moller HD, Fu FH. Bone tunnel enlargement after anterior cruciate ligament reconstruction: Fact or fiction. Knee Surg Sports Traumatol Arthrosc. 1998;6:231–240
  13. Insalata JC, Klatt B, Fu FH, Harner CD. Tunnel expansion following anterior cruciate ligament reconstruction: A comparison of hamstring and patellar tendon autografts. Knee Surg Sports Traumatol Arthrosc. 1997;5:234–238
  14. Jansson KA, Harilainen A, Sandelin J, Karjalainen PT, Aronen HJ, Tallroth K. Bone tunnel enlargement after anterior cruciate ligament reconstruction with the hamstring autograft and endobutton fixation technique (A clinical, radiographic and magnetic resonance imaging study with 2 years follow-up). Knee Surg Sports Traumatol Arthrosc. 1997;7:290–295
  15. Klein JP, Litner DM, Downs D, Varenka K. The incidence and significance of femoral tunnel widening after quadrupled hamstring anterior cruciate ligament reconstruction using femoral cross pin fixation. Arthroscopy. 2003;19:470–476
  16. Nebelung W, Becker R, Merkel M, Ropke M. Bone tunnel enlargement after anterior cruciate ligament reconstruction with semitendinosus tendon using Endobutton fixation on the femoral side. Arthroscopy. 1998;14:810–815
  17. Peyrache MD, Dijan P, Christel P, Witvoet J. Tibial tunnel enlargement after anterior cruciate ligament reconstruction by autogenous bone-patellar tendon-bone graft. Knee Surg Sports Traumatol Arthrosc. 1996;4:2–8
  18. Schulte K, Majewski M, Irrgang JJ, et al. Radiographic tunnel changes following arthroscopic ACL reconstruction: Autograft versus allograft. Arthroscopy. 1995;11:372–373
  19. Segawa H, Omori G, Tomita S, Koga Y. Bone tunnel enlargement after anterior cruciate ligament reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc. 2001;9:206–210
  20. Simonian PT, Erickson MS, Larson RV, O’kane JW. Tunnel expansion after hamstring anterior cruciate ligament reconstruction with a 1-incision EndoButton femoral fixation. Arthroscopy. 2000;16:707–714
  21. Simonian PT, Monson JT, Larson RV. Biodegradable interference screw augmentation reduces tunnel expansion after ACL reconstruction. Am J Knee Surg. 2001;14:104–108
  22. Webster KE, Feller JA, Harmeister KA. Bone tunnel enlargement following anterior cruciate ligament reconstruction: A randomised comparison of hamstring and patellar tendon grafts with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2001;9:86–91
  23. Wilson TC, Kantaras A, Atay A, Johnson DL. Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med. 2004;32:543–549
  24. Yu JK, Paessler HH. Relationship between tunnel widening and different rehabilitation procedures after ACL reconstruction with quadrupled hamstring tendons. Zhonghua Wai Ke Za Zhi. 2004;42:984–988(in Chinese)
  25. Zijl JAC, Kleipool AEB, Willems WJ. Comparison of tibial tunnel enlargement after anterior cruciate ligament reconstruction using patellar tendon autograft or allograft. Am J Sports Med. 2000;28:547–551
  26. Cha PS, Chhabra A, Harner CD. Single-bundle anterior cruciate ligament reconstruction using the medial portal technique. Oper Tech Orthop. 2005;15:85–89
  27. Harner CD, Baek GH, Vogrin TM, Carlin GJ, Kashiwaguchi S, Woo SL. Quantitative analysis of human cruciate ligament insertions. Arthroscopy. 1999;15:741–749
  28. Loh JC, Fukada Y, Tsuda E, Steadman RJ, Fu FH, Woo SL. Knee stability and graft function following anterior cruciate ligament reconstruction (Comparison between 11 o’clock and 10 o’clock femoral tunnel placement: 2002 Richard O’Connor Award paper). Arthroscopy. 2003;19:297–304
  29. Ma CB, Francis K, Towers J, Irrgang J, Fu FH, Harner CH. Hamstring anterior cruciate ligament reconstruction: A comparison of bioabsorbable interference screw and EndoButton-post fixation. Arthroscopy. 2004;20:122–128

 The authors report no conflict of interest.

PII: S0749-8063(06)00740-7

doi: 10.1016/j.arthro.2006.05.019

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 22, Issue 10 , Pages 1107-1112 , October 2006

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