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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 April;64(2):121-7
Does femoral back wall failure affect the functional results of arthroscopic anterior cruciate ligament surgery?
Elmadag M. 1, Erdil M. 1, Bilsel K. 1, Ali Acar M. 2, Tuncay I. 1, Yel M. 3 ✉
1 Department of Orthopedics and Traumatology, Bezmialem Vakif University, School of Medicine, Istanbul, Turkey;
2 Department of Orthopedics and Traumatology, Selcuk University, Selcuklu Medicine Faculty, Konya, Turkey;
3 Department of Orthopedics and Traumatology, Selcuk University, Meram School of Medicine, Konya, Turkey
Aim: The aim of the study was to evaluate the effects of femoral back wall failure (FBWF) due to tunnel enlargement after anterior cruciate ligament (ACL) surgery on clinical outcomes.
Methods: The functional results of 40 ACL reconstructions were evaluated prospectively. The study includes ACL reconstructions with transtibial single bundle technique with hamstring autografts whereas those with concomitant knee ligament injuries were excluded. Tunnel enlargements were measured with CT scan at the end of the 12th month after surgery. Functional results were evaluated at the first year follow-up by an anterior drawer test, Lachman test, rollimeter, IKDC, and Lysholm Knee Scale.
Results: Femoral and tibial tunnel enlargement was measured in all of our patients with 39% mean enlargement in femoral tunnels and 48% in tibial tunnels. No significant correlation between amount of tunnel enlargement and clinical outcomes was obtained. Additionally, no significant correlation between tibial fixation type and tibial tunnel enlargement was found (P>0.05). In nine patients (22.5%), FBWF was evaluated. These nine patients did not show any significant difference in clinical outcomes than the other 31 patients (P>0.05).
Conclusion: Excessive femoral tunnel enlargements after ACL surgeries may lead FBWF. This pathology does not affect clinical outcomes. However, FBWF with bone defect may cause more complicated ACL revision surgery. This fact must be kept in mind by orthopedic surgeons.