title: Early integration of a bone plug in the femoral tunnel in rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: a prospective computed tomography analysis.
abstract: OBJECTIVE
  The purpose of this prospective study was to evaluate how early the bone plug was integrated into the rectangular femoral tunnel after anatomical ACL reconstruction using a bone-patellar tendon-bone (BTB) graft via a rectangular tunnel (RT BTB ACL-R).
  
  
  METHODS
  Twenty consecutive patients who had undergone the reconstruction procedure were evaluated by CT scans at 4 and 8 weeks postoperatively. In each scan, 30 slices for multiplanar reconstruction were collected parallel to the long axis of the parallelepiped femoral tunnel and perpendicular to the tendinous plane of the bone plug. Each slice was classified as "complete," indicating no visible gap between the plug and the tunnel wall or trabecular continuity or "incomplete," showing a visible gap. Bone plug-tunnel integration was evaluated as "excellent," "good," "fair," or "poor" for >20, 11-20, 5-10, and <4 "complete" slices, respectively.
  
  
  RESULTS
  In this evaluation, 55% of the patients were rated as "excellent" on the first scan, and 80% were "excellent" on the second scan, showing healing over time. The CT values at the anterior interface between the bone plug and the tunnel wall were also measured on both scans. The mean changes in CT value at 8 weeks were significantly lower than those at 4 weeks.
  
  
  CONCLUSIONS
  This study shows that bone plug-femoral tunnel integration was almost complete by 8 weeks after surgery using RT BTB ACL-R.
authors: Department of Orthopaedics, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8456, Japan. suzutomo@sapmed.ac.jp
authors: Tomoyuki
authors: T
authors: Suzuki
authors: Konsei
authors: K
authors: Shino
authors: Shigeto
authors: S
authors: Nakagawa
authors: Ken
authors: K
authors: Nakata
authors: Takehiko
authors: T
authors: Iwahashi
authors: Kazutaka
authors: K
authors: Kinugasa
authors: Hidenori
authors: H
authors: Otsubo
authors: Toshihiko
authors: T
authors: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D050376:Bone-Patellar Tendon-Bone Grafting / Q000000981:diagnostic imaging*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome