Measurements of bone tunnel size in anterior cruciate ligament reconstruction: 2D versus 3D computed tomography model View Full Text


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Article Info

DATE

2014-06-26

AUTHORS

Bernardo Crespo, Cathrine Aga, Katharine J Wilson, Shannon M Pomeroy, Robert F LaPrade, Lars Engebretsen, Coen A Wijdicks

ABSTRACT

BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction requires a precise evaluation of previous tunnel locations and diameters. Enlargement of the tunnels, despite not usually affecting primary reconstruction outcomes, plays an important role in revision ACL management. Three dimensional (3D) computed tomography (CT) models are reported to be the most accurate method for identifying the tunnel position and possible conflicts with a revision tunnel placement. However, the ability of 3D CT to measure the tunnel size is still not proven. The goal of this study was to evaluate the ability of measuring the size of the bone tunnels in ACL reconstructed knees with 3D CT compared to the traditional two dimensional (2D) CT method. METHODS: Twenty-four patients had CT scans performed immediately following ACL reconstruction surgery. Their femoral tunnels size were measured by a standard 2D CT measurement and then compared with three novel 3D CT measuring methods: the best transverse section method, the best fit cylinder method and the wall thickness method. The drill size used during surgery was used as a control measure for the tunnel width. Intra-class correlation coefficients were obtained. RESULTS: The intra-class correlation coefficient and respective 95% confidence interval range (ICC [95%CI]) for the three methods compared with the drill sizes were 0.899 [0.811-0.947] for the best transverse section method, 0.745 [0.553-0.862] for the best fit cylinder method, -0.004 [-0.081 to -0.12] for the wall thickness method and 0.922 [0.713-0.97] for the 2D CT method. The mean differences compared to the drill size were 0.02 mm for the best fit transverse section method, 0.01 mm for the best fit cylinder diameter method, 3.34 mm for the wall thickness method and 0.29 mm for the 2D CT method. The intra-rater agreement (ICC [95%CI]) was excellent for the best transverse section method 0.999 [0.998-0.999] and the 2D CT method 0.969 [0.941-0.984]. CONCLUSIONS: The 3D best transverse section method presented a high correlation to the drill sizes and high intra-rater agreement, and was the best method for ACL tunnel evaluation in a 3D CT based model. More... »

PAGES

2

References to SciGraph publications

  • 2009-12-02. Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 1996-03. Tibial tunnel enlargement after anterior cruciate ligament reconstruction by autogenous bone-patellar tendon-bone graft in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2001-02-27. Bone tunnel enlargement following anterior cruciate ligament reconstruction: a randomised comparison of hamstring and patellar tendon grafts with 2-year follow-up in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 1999-05. Tunnel widening in anterior cruciate ligament reconstruction: a prospective evaluation of hamstring and patella tendon grafts in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-01-20. Medial portal technique for single-bundle anatomical Anterior Cruciate Ligament (ACL) reconstruction in INTERNATIONAL ORTHOPAEDICS
  • 2006-12-06. The effect of accelerated, brace free, rehabilitation on bone tunnel enlargement after ACL reconstruction using hamstring tendons: a CT study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-04-12. Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 1998-10. Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-02-25. Comparisons of femoral tunnel enlargement in 169 patients between single-bundle and anatomic double-bundle anterior cruciate ligament reconstructions with hamstring tendon grafts in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-11-23. Indications and contraindications for double-bundle ACL reconstruction in INTERNATIONAL ORTHOPAEDICS
  • 2007-01-10. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-10-26. Radiological evaluation for conflict of the femoral tunnel entrance area prior to anterior cruciate ligament revision surgery in INTERNATIONAL ORTHOPAEDICS
  • 2011-12-31. Transtibial ACL reconstruction technique fails to position drill tunnels anatomically in vivo 3D CT study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1186/s40634-014-0002-0

    DOI

    http://dx.doi.org/10.1186/s40634-014-0002-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1014751182

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26914747


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    85 position
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    89 primary reconstruction outcomes
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    92 reconstruction outcomes
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    94 revision ACL management
    95 revision anterior cruciate ligament reconstruction
    96 revision tunnel placement
    97 role
    98 scans
    99 section method
    100 size
    101 standard 2D CT measurement
    102 study
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    104 thickness method
    105 tomography models
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    109 tunnel location
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    111 tunnel position
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