ReviewKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Tibial tunnel expansion does not correlate with four-strand graft maturation after ACL reconstruction using adjustable cortical suspensory fixation.
Review in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- MRI Evaluation of Graft Remodeling After Transphyseal Anterior Cruciate Ligament Reconstruction in Pediatric Patients: A 5-Year Follow-up.Orthopaedic journal of sports medicine · 2026Article
- Radiologic maturation and tunnel changes after all-inside versus standard hamstring ACL reconstruction: a prospective comparative study.La Radiologia medica · 2026Article
- Mid-Term Tibial Tunnel Enlargement and Graft Maturation After ACL Reconstruction: A 5-Year Follow-Up Linking Morphological Dynamics to Knee Function.Orthopaedic surgery · 2026Article
- The use of additional strands to increase graft diameter in primary ACL reconstruction provides optimal outcomes and does not compromise healing at 12-months follow-up.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Partial Transphyseal All-Inside Anterior Cruciate Ligament Reconstruction in Skeletally Immature Adolescent Patients: Two-Year Minimum Follow-up Clinical and Radiologic Results.Orthopaedic journal of sports medicine · 2025Article
- Gradual stabilization and narrowing of bone tunnels following primary anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Tendon Groove Technique: A Double-Bundle Footprint Technique for Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2024Article
- Neglected errors in ligament reconstruction surgery may increase graft-tunnel mismatch: A biomechanical study.PloS one · 2024Article
- Serial change of femoral and tibial tunnel width after anterior cruciate ligament reconstruction with allograft.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Beneficial Effect of Curved Dilator System for Femoral Tunnel Creation in Preventing Femoral Tunnel Widening after Anterior Cruciate Ligament Reconstruction.Medicina (Kaunas, Lithuania) · 2023Article
- Current trends in graft choice for anterior cruciate ligament reconstruction - part I: anatomy, biomechanics, graft incorporation and fixation.Journal of experimental orthopaedics · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAnterior cruciate ligament reconstruction (ACLR) using a short, quadrupled semitendinosus (ST-4) autograft, fixed with an adjustable suspensory fixation (ASF), has several potential advantages. However, the construct is suspected to generate micromotion, tunnel widening and poor graft maturation. The aim of this study was to evaluate post-operative tibial tunnel expansion, graft maturation and clinical outcomes for this type of ACLR.
methodsOne-hundred and forty-nine patients were reviewed at a minimum of 2 years following 4-ST ACLR, mean 25.6 ± 3.5 months [24-55], with clinical follow-up and MRI scans. Graft maturity of the intra-articular part of the graft and the tibial tunnel portion was assessed using Signal-to-Noise Quotient (SNQ) and Howell score. Tibial tunnel expansion, bone-graft contact and graft volume in the tibial tunnel were calculated from the MRI scans.
resultsMean tibial tunnel expansion was 13 ± 16.5% [12-122]. Mean SNQ for graft within the tibial tunnel was 3.8 ± 7.1 [ - 7.7 to 39] and 2.0 ± 3.5 [ - 14 to 17] for the intra-articular portion of the graft. The Howell score for graft within the tibial tunnel was 41% Grade I, 37% Grade 2, 20% Grade 3, 2% grade 4, and for the intra-articular part 61% Grade 1, 26% Grade 2, 13% Grade 3 and 1% Grade 4. The mean tibial tunnel bone-graft contact was 81 ± 23% [0-100] and mean graft volume was 80 ± 22% [0-100]. No correlation was found between tibial tunnel expansion and graft maturity assessed at both locations. Graft maturity was correlated with higher graft-bone contact and graft volume in the tibial tunnel (p < 0.05).
conclusionsST-4 ACLR with ASF had low levels of tunnel enlargement at 2 years. No correlation was found between graft maturation and tibial tunnel expansion. Graft maturity was correlated with graft-bone contact and graft volume in the tibial tunnel. LEVEL OF EVIDENCE: Level III.
Indexed as
Identifiers
35876906What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.