Purpose
The purpose of this study was to evaluate and compare femoral and tibial tunnel volume
enlargement (TVE) after arthroscopic posterior cruciate ligament (PCL) reconstruction
by remnant bundle preservation using Achilles allograft or mixed graft.
Methods
Seventy-eight patients undergoing primary arthroscopic single-bundle PCL reconstruction
were initially included. Fifty-six of these patients underwent follow-up for a minimum
of 1 year postoperatively and were divided into 2 groups: group A received Achilles
allograft (n = 27), and group B received mixed graft (n = 29). The clinical evaluation
included the International Knee Documentation Committee rating, Lysholm score, Tegner
activity score, and Telos stress test (Telos, Weiterstadt, Germany). All of the patients
were evaluated for TVE by computed tomography scanning at the 1-year follow-up; the
results were compared with the data from 1 week postoperatively. A volume increment
of more than 44%, which indicates 2 mm of widening of the tunnel diameter, was defined
as TVE.
Results
The overall incidence of TVE after single-bundle PCL reconstruction was 3.6% (2 of
56 patients) for the femoral tunnel and 5.4% (3 of 56 patients) for the tibial tunnel.
The overall mean tunnel difference between 1 week postoperatively and the final follow-up
was 12.0% for the femoral tunnel and 10.6% for the tibial tunnel. The mean femoral
TVE was 10.1% in group A and 13.8% in group B; the mean tibial TVE was 9.9% in group
A and 11.2% in group B. These differences were not statistically significant. The
functional outcome was improved in both groups, showing no statistical difference
at the 1-year follow-up.
Conclusions
The femoral and tibial TVE caused by single-bundle PCL reconstruction using the remnant
bundle–preservation technique showed no significant differences between the Achilles
allograft and the mixed graft over a short-term follow-up. Furthermore, the overall
incidence of TVE in PCL reconstruction in this study was low.
Level of Evidence
Level II, prospective comparative study.
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Article info
Publication history
Accepted:
December 11,
2013
Received:
June 5,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: K.W.N. receives support from a 2014 Inje University Research Grant.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
