ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Relationship between bone plug position and morphological changes of tunnel aperture in anatomic rectangular tunnel ACL reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 18 citations in OpenAlex.
- Biologically Augmented Hamstring Autograft Anterior Cruciate Ligament Reconstruction With Arthroscopically Harvested Minced Anterior Cruciate Ligament Remnant.Arthroscopy techniques · 2025Article
- Comparison of Outcomes Between a Fixed-Loop Cortical Suspensory Device and Metal Interference Screw for Femoral Fixation of Bone-Patellar Tendon-Bone Grafts in Anterior Cruciate Ligament Reconstruction: A Scandinavian Registry Study.Orthopaedic journal of sports medicine · 2025Article
- Bone-Patellar Tendon-Bone Versus Quadriceps Tendon-Bone Autografts in Anatomic Rectangular Tunnel Anterior Cruciate Ligament Reconstruction.Orthopaedic journal of sports medicine · 2024Article
- Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study.Journal of experimental orthopaedics · 2023Article
- Posteromedial Portal Technique With Bone-Patellar Tendon-Bone Graft for Inside-Out Revision of Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2023Article
- Increased Bone Plug Depth From the Joint Increases Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft With Suspensory Femoral Fixation.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- Lateral posterior tibial slope does not affect femoral but does affect tibial tunnel widening following anatomic anterior cruciate ligament reconstruction using a Bone-Patellar Tendon-Bone graft.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2022Article
- A more flattened bone tunnel has a positive effect on tendon-bone healing in the early period after ACL reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn animal studies after ACL reconstruction (ACL-R) using the bone-patellar tendon-bone (BTB), the graft-healing pattern was found to depend on the relationship between bone plug and the tunnel wall. This difference of graft-healing pattern could influence the postoperative morphological changes of the tunnel. However, no study has assessed the relationship between bone plug position and the change of tunnel morphology. Therefore, the main purpose of this study was to investigate the relationship between the bone plug position within femoral or tibial tunnel and morphological changes of each tunnel aperture in ACL-R using computed tomography.
methodsSubjects were 30 consecutive patients (six females and 24 males; mean age, 20.4 ± 5.4 years) who underwent primary ACL-R using BTB. The distance from the tunnel aperture to the tendon-bone junction (TBJ) at 2 weeks postoperatively, and tunnel aperture enlargement and tunnel wall migration from 2 weeks to 6 months postoperatively, were evaluated.
resultsThe distance from the femoral tunnel aperture to the TBJ in most cases was less than 2 mm, whereas the TBJ was located within the tibial tunnel. Femoral tunnel aperture was significantly enlarged (17.0 ± 11.7%) distally, and the tibial tunnel aperture was significantly enlarged (19.6 ± 12.5%) posterolaterally. Only the position at distal portion of femoral bone plug was correlated with femoral tunnel aperture enlargement (r = 0.454, p = 0.0015).
conclusionBoth femoral and tibial tunnel aperture were significantly enlarged distally and posterolaterally 6 months postoperatively. Only correlation between the position at distal portion of femoral bone plug and femoral tunnel enlargement were found, suggesting the deep plug position in the tunnel is a risk factor for femoral tunnel enlargement, highlighting the importance of accurately locating the TBJ just at the femoral tunnel aperture. Another option is to deviate the harvest site in the patellar tendon to match the shape of the TBJ and the tunnel aperture. LEVEL OF EVIDENCE: 4 (case series).
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