[Effect of bone tunnel diameter on anterior cruciate ligament insertion outcome].
OBJECTIVE
To observe the histology change of the insertion using different diametrical bone tunnel in anterior cruciate ligament (ACL) reconstruction.


METHODS
Ninety Japanese rabbits were selected, mihout female and male limit, weighing 2.5-3.0 kg, and were randomly divided into 3 groups, 30 in each group. The ratio of transplantation ligament diameter and bone tunnel diameter was 1/1 (group A), the ratio was 1/1.5 (group B), and the ratio was 1/2 (group C). Bone tunnel observation and histology observation were carried out in the 4th, 8th and 16th weeks postoperatively.


RESULTS
Wound healed well in 3 groups. The mean time of walking functional recovery was 1.5, 2.0 and 3.5 days in groups A, B and C respectively. After 4 weeks of operation, more soft tissues at tunnel entry were observed in group A and group B than in group C; after 8 weeks of operation, there was no crevice at bone-tunnel entry of the groups A and B, there was no improvement in group C; after 16 weeks of operation, groups A and B showed the normal insertion, group C had no normal insertion. Histology observation: in groups A, B and C, bone-tunnel was filled with loose connective tissue after 4 weeks of operation; group A and group B emerged the discontinuation ACL insertion tidal line after 8 weeks of operation, group C had no insertion; groups A and B emerged the similarity normal ACL insertion tidal line structure after 16 weeks of operation, but group C had no this structure. The results of ultimate tensile strength in groups A, B and C were (75.44 +/- 7.06), (91.37 +/- 6.14) and (126.91 +/- 4.61) N respectively at 4 weeks; the results were (74.31 +/- 4.81), (88.30 +/- 7.46) and (124.34+/- 8.44) N respectively at 8 weeks; and the results were (62.20 +/- 5.32), (71.53 +/- 5.99) and (83.62 +/- 5.69) N respectively at 16 weeks. There was no significant difference between group A and group B (P > 0.05), and there were significant differences between groups A, B and group C (P < 0.05).


CONCLUSIONS
In the ACL reconstruction, the ratio of transplantation ligament diameter and bone tunnel diameter being 1/1.5 will not affect the insertion outcome, but if the ratio less than the limit it will affect the insertion outcome.
Zhang
Pei
P
Department of Orthopedic Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R. China.
Liu
Quan
Q
Zhou
Jiansheng
J
Liu
Zhenhua
Z
Xiao
Yuzhou
Y
Xiang
Ping
P
Hu
Ruqi
R
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000502:physiology* / Q000601:surgery / Q000637:transplantation*; D050376:Bone-Patellar Tendon-Bone Grafting; D005269:Femur / Q000033:anatomy & histology*; D007719:Knee Joint / Q000601:surgery; D011817:Rabbits