Bone Plug Fixation in ACL Reconstruction: A Clinical and Radiological Assessment of Post-Operative Tunnel Widening

Authors

The Department of Orthopedic Surgery, Faculty of Medicine, Cairo University

Abstract

Abstract Background: The decision regarding graft choice and fixation in ACL reconstruction procedure remains controversial. Free cylindrical bone plugs has been used as a graft fixation method successfully. Still some concerns exist about how well these plugs integrate with the bony walls of the tunnel. Aim of Study: Is to assess bone to bone healing and tunnel widening, and evaluating its effect on the clinical outcomes of the procedure. Patients and Methods: From January 2015 to December 2017, 30 patients (21-40 yrs) with torn ACL were operated upon and followed-up for 24 months after surgery. All patients were assessed clinically using (IKDC & T-L), instrumentally (KT1000 & Rolimeter), and radiologically with X-rays, CT & MRI. Young active patients with torn ACL were included while those with previous ligamentous injury and/or surgery were excluded. Results: All bone grafts showed solid bone healing after 6 months of surgery; bone healing is Good to Excellent (Tibial side; 66.6%-Femoral Side; 86.6%). No correlation between age or time interval with graft incorporation. Positive corre-lation shown between tibial and femoral graft incorporation within the same patient. Only one patient abnormal in our final Objective IKDC scores (graded C). The mean side-to-side differences with KT 1000 and Rolimeter was 1.9 and 1.8 respectively. Conclusion: Free cylindrical bone plug could be used safely for hamstring tendon graft fixation. It enhances bone to bone healing and tunnel narrowing within the first 6 months. It yields comparable clinical outcomes yet avoiding potential hazards of foreign hardware implants. Study Design: Case series.

Keywords

The Medical Journal of Cairo University
Volume 89, December
December 2021
Pages 3039-3047

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