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Is a grafted tendon flattened at the tunnel aperture after anatomical flat anterior cruciate ligament reconstruction using hamstring autograft?
ESSKA Academy. Hayashi M. Nov 8, 2019; 284427; epESMA-14 Topic: Arthroscopic Surgery
Masaya Hayashi
Masaya Hayashi
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Is a grafted tendon flattened at the tunnel aperture after anatomical flat anterior cruciate ligament reconstruction using hamstring autograft?

ePoster - epESMA-14

Topic: Sports Trauma

Hayashi M., Yoshimura H., Ogiuchi T., Takahashi T., Matsumura E., Nakamura K., Uomizu M., Hasegawa S., Seki R., Hoshino A.
Kawaguchi Kogyo General Hospital, Orthopaedic Surgery, Kawaguchi, Japan

Introduction: Rectangular tunnel anterior crusiate ligament (ACL) reconstruction using bone-patellar tendon-bone graft can mimic the flat morphology and fiber sequence of the native ACL and reports on good clinical outcome. In ACL reconstruction using hamstring tendon autograft, we also open rectangular bone tunnel aiming for flat ligament reconstruction akin to native ACL, however there is a concern as to whether the transplanted tendon maintains a flattened shape in the bone tunnel.
Objectives: The subjects included 22 patients who underwent MRI within 4 weeks after surgery. Proton density weighted images were used in this study, and a cross section perpendicular to the bone tunnel was created for both tibia and femur. The occupancy rate and flattening of the grafted tendon in the bone tunnel were measured using image J. Specifically, NIH Image J version 1.51 was used to show the bone tunnel aperture area (a), the transplanted tendon sectional area at tunnel aperture (b), the transplanted tendon cross-sectional long axis (c), and the transplanted tendon cross-sectional minor axis (d) was measured on both the femur and the tibial side. Furthermore, the graft occupancy rate and the flattening of the graft were obtained using the following expressions, respectively.
Graft occupancy rate = b / a
Flattening = (c - d) / c
Results: The average occupancy rate of the grafted tendon at the tunnel aperture was 0.62 on the femoral side and 0.65 on the tibial side, and the flattening was 0.48 on the femoral side and 0.35 on the tibial side.
Conclusions: In anatomical flat ACL reconstruction using hamstring autograft, the grafted tendon maintained a flattened shape at the aperture of the bone tunnel immediately after surgery.
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