Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 4 , Pages 481-487 , April 2010

The Relation Between Tunnel Widening and Bone Mineral Density After Anterior Cruciate Ligament Reconstruction: An Experimental Study in Sheep

  • Rupert Meller, M.D.

      Affiliations

    • Trauma Department, Hannover Medical School, Hannover, Germany
    • Corresponding Author InformationAddress correspondence and reprint requests to Rupert Meller, M.D., Trauma Department, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
    • ,
  • Alexandra Neddermann, D.V.M.

      Affiliations

    • Orthopaedic Department, Hannover Medical School, Hannover, Germany
    • ,
  • Elmar Willbold, M.D.

      Affiliations

    • Orthopaedic Department, Hannover Medical School, Hannover, Germany
    • ,
  • Eric Hesse, Ph.D.

      Affiliations

    • Trauma Department, Hannover Medical School, Hannover, Germany
    • ,
  • Carl Haasper, M.D.

      Affiliations

    • Trauma Department, Hannover Medical School, Hannover, Germany
    • ,
  • Anshu Singh, M.D.

      Affiliations

    • Harvard Shoulder Service, Boston, Massachusetts, U.S.A.
    • ,
  • Karsten Knobloch, M.D.

      Affiliations

    • Department of Plastic, Hand, and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
    • ,
  • Christian Krettek, M.D., F.R.A.C.S.

      Affiliations

    • Trauma Department, Hannover Medical School, Hannover, Germany
    • ,
  • Stefan Hankemeier, M.D.

      Affiliations

    • Trauma Department, Hannover Medical School, Hannover, Germany

Received 19 March 2009 ,Accepted 30 August 2009.

References 

  1. Doschak MR, Wohl GR, Hanley DA, Bray RC, Zernicke RF. Antiresorptive therapy conserves some periarticular bone and ligament mechanical properties after anterior cruciate ligament disruption in the rabbit knee. J Orthop Res. 2004;22:942–948
  2. Leppala J, Kannus P, Natri A, et al. Effect of anterior cruciate ligament injury of the knee on bone mineral density of the spine and affected lower extremity: A prospective one-year follow-up study. Calcif Tissue Int. 1999;64:357–363
  3. Rittweger J, Maffulli N, Maganaris CN, Narici MV. Reconstruction of the anterior cruciate ligament with a patella-tendon-bone graft may lead to a permanent loss of bone mineral content due to decreased patellar tendon stiffness. Med Hypotheses. 2005;64:1166–1169
  4. Boyd SK, Matyas JR, Wohl GR, Kantzas A, Zernicke RF. Early regional adaptation of periarticular bone mineral density after anterior cruciate ligament injury. J Appl Physiol. 2000;89:2359–2364
  5. Bayar A, Sarikaya S, Keser S, Ozdolap S, Tuncay I, Ege A. Regional bone density changes in anterior cruciate ligament deficient knees: A DEXA study. Knee. 2008;15:373–377
  6. Shymkiw RC, Bray RC, Boyd SK, Kantzas A, Zernicke RF. Physiological and mechanical adaptation of periarticular cancellous bone after joint ligament injury. J Appl Physiol. 2001;90:1083–1087
  7. Kannus P, Sievanen H, Jarvinen M, Heinonen A, Oja P, Vuori I. A cruciate ligament injury produces considerable, permanent osteoporosis in the affected knee. J Bone Miner Res. 1992;7:1429–1434
  8. Nyland J, Kocabey Y, Caborn DN. Insertion torque pullout strength relationship of soft tissue tendon graft tibia tunnel fixation with a bioabsorbable interference screw. Arthroscopy. 2004;20:379–384
  9. Selby JB, Johnson DL, Hester P, Caborn DN. Effect of screw length on bioabsorbable interference screw fixation in a tibial bone tunnel. Am J Sports Med. 2001;29:614–619
  10. Brand JC, Pienkowski D, Steenlage E, Hamilton D, Johnson DL, Caborn DN. Interference screw fixation strength of a quadrupled hamstring tendon graft is directly related to bone mineral density and insertion torque. Am J Sports Med. 2000;28:705–710
  11. Jarvinen TL, Nurmi JT, Sievanen H. Bone density and insertion torque as predictors of anterior cruciate ligament graft fixation strength. Am J Sports Med. 2004;32:1421–1429
  12. 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
  13. Kaymakci B, Wark JD. Precise accurate mineral measurements of excised sheep bones using X-ray densitometry. Bone Miner. 1994;25:231–246
  14. Turner AS, Mallinckrodt CH, Alvis MR, Bryant HU. Dual-energy X-ray absorptiometry in sheep: Experiences with in vivo and ex vivo studies. Bone. 1995;17:381S–387S
  15. Wohl GR, Shymkiw RC, Matyas JR, Kloiber R, Zernicke RF. Periarticular cancellous bone changes following anterior cruciate ligament injury. J Appl Physiol. 2001;91:336–342
  16. Schultz WR, McKissick RC, DeLee JC. Tibial tunnel widening after hamstring tendon anterior cruciate ligament reconstruction: The effect of supplemental aperture fixation with autogenous bone cores. Am J Sports Med. 2007;35:1725–1730
  17. Fahey M, Indelicato PA. Bone tunnel enlargement after anterior cruciate ligament replacement. Am J Sports Med. 1994;22:410–414
  18. Wilson TC, Kantaras A, Atay A, Johnson DL. Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med. 2004;32:543–549
  19. Zerahn B, Munk AO, Helweg J, Hovgaard C. Bone mineral density in the proximal tibia and calcaneus before and after arthroscopic reconstruction of the anterior cruciate ligament. Arthroscopy. 2006;22:265–269
  20. 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
  21. Simonian PT, Erickson MS, Larson RV, O'Kane JW. Tunnel expansion after hamstring anterior cruciate ligament reconstruction with 1-incision EndoButton femoral fixation. Arthroscopy. 2000;16:707–714
  22. Neddermann A, Willbold E, Witte F, et al. Tunnel widening after anterior cruciate ligament reconstruction: An experimental study in sheep. Am J Sports Med. 2009;37:1609–1617

 Supported by a grant from the Regional Science Council, Hannover Medical School (HILF 79420010). The authors report no conflict of interest.

 

Note: To access the video accompanying this report, visit the April issue of Arthroscopy at www.arthroscopyjournal.org.

PII: S0749-8063(09)00784-1

doi: 10.1016/j.arthro.2009.08.025

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 4 , Pages 481-487 , April 2010

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