Gross osteolytic tibia tunnel widening with the use of Gore-Tex anterior cruciate ligament prosthesis: a radiological, arthrometric and clinical evaluation of 17 patients 13-15 years after surgery.
BACKGROUND
Postoperative widening of the bone tunnels have been found after anterior cruciate ligament reconstruction using autologus bone-patellar tendon-bone or hamstring tendon grafts. These changes seem to be of no clinical significance in a short to midterm follow-up. We investigated if a synthetic graft evokes the same bone tunnel widening and if it is of clinical significance in a longterm follow-up.


METHODS
We examined 17 patients, 13-15 years after their anterior cruciate ligament reconstruction using a Gore-Tex ligament prosthesis. The follow-up consisted of clinical examination, K-1000 arthrometric measurement, Tegner, Lysholm and IKDC scores, and CT examination of their tibia bone tunnels. 6 patients had been reoperated before follow-up, 3 because of graft rupture and 3 because of effusion and/or pain.


RESULTS
5 patients were graded as normal (n = 2) or nearly normal according to the IKDC score, and 4 of these patients still had their Gore-Tex prosthesis intact. 15 of the patients had a tibia bone tunnel wider than the drilled 7.9 mm diameter, ranging from 9.6 to 26 mm. These changes in the bone tunnels were in some cases without symptoms and could not be detected with arthroscopy, clinical examination, arthrometry or evaluation scores. We do not know whether they are progressive.


CONCLUSIONS
Based on our findings, we recommend that patients who have had a Gore-Tex anterior cruciate ligament reconstruction should be examined not only clinically or by questionnaire, but also with CT.
Muren
Olle
O
Department of Orthopedics, Danderyd Hospital, SE-182 88 Stockholm, Sweden. olav.muren@ds.se
Dahlstedt
Lars
L
Brosjö
Eva
E
Dahlborn
Mats
M
Dalén
Nils
N
D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D000886:Anthropometry; D005500:Follow-Up Studies; D006801:Humans; D010014:Osteolysis / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed