[Influence of the postoperative activity level on tibial bone tunnel enlargement and functional treatment results following anterior cruciate ligament reconstruction using a patellar tendon autograft].
OBJECTIVE
This study was performed to evaluate the influence of the postoperative activity level on tibial bone tunnel enlargement following anterior cruciate ligament reconstruction using a mid-third patellar tendon autograft.


METHODS
A clinical and radiological assessment was performed on 50 patients (21 male, 29 female, mean age 32 years, range 18 to 57 years) following ACL reconstruction using a patellar tendon autograft. The average follow-up examination was performed 18 (12 to 30) months after the operation.


RESULTS
33 patients (66 %) developed a tibial bone tunnel enlargement > 1 mm. We found a positive correlation (+ 0.59) of the grade of activity and the muscle status (+ 0.56) to the tibial bone tunnel enlargement. Patients with a major tibial bone tunnel enlargement performed at a higher (p < 0.05) postoperative activity grade (5.2 versus 4.1 in the Tegner grading), rated higher in the Lysholm (88 versus 77 points) and IKDC scores (p < 0.05) and reported a better subjective functional outcome (p < 0.05). There was no significant correlation of the results of the knee stability tests and the age of the patients to the grade of tibial bone tunnel enlargement.


CONCLUSIONS
In ACL reconstruction using a patellar tendon autograft we recommend early rehabilitation as the concomitant tibial bone tunnel enlargement does not significantly influence the clinical outcome or knee stability.
Bohnsack
M
M
Orthopädische Klinik der Medizinischen Hochschule Hannover, Klinik II im Annastift, Anna-Von-Borries-Strasse 1-7, 30625 Hannover. bohnsack@annastift.de
Hehl
S
S
Möller
H
H
Börner
C
C
Wirth
C J
CJ
Rühmann
O
O
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017847:Patellar Ligament / Q000637:transplantation*; D011182:Postoperative Care / Q000379:methods*; D011859:Radiography; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013977:Tibia / Q000000981:diagnostic imaging*; D016896:Treatment Outcome