title: Femoral tunnel enlargement after anterior cruciate ligament reconstruction using RigidFix compared with extracortical fixation.
abstract: OBJECTIVE
  The aim of this study was to compare femoral tunnel enlargement after anterior cruciate ligament (ACL) reconstruction surgery using hamstring autograft tendons fixed by bioabsorbable femoral trans-tunnel pins with that in patients in which the graft was fixed with extracortical fixation.
  
  
  METHODS
  Forty-three patients were randomly selected from our database and included in the study. Femoral tunnel diameter was measured by computed tomography in 20 patients who underwent ACL reconstruction via anteromedial portal technique using autologous quadruple hamstrings, fixed with two bioabsorbable trans-tunnel pins, RigidFix, on the femoral side and compared with 23 patients in whom extracortical fixation, EndoButton CL, was used. The diameter of the femoral tunnel was measured at a distance of 5 mm from the tunnel entrance and at the largest diameter along the tunnel axis. Data were compared with the diameter of the drill used during surgery. Clinical evaluation was performed using the Lysholm score, IKDC subjective score and anterior knee laxity measurements.
  
  
  RESULTS
  Femoral tunnel enlargement 5 mm from the entrance and at the largest diameter was greater in the RigidFix group than the EndoButton group. There were no significant differences between the two groups regarding age, gender, post-operative Lysholm score, IKDC subjective score or knee laxity measurements.
  
  
  CONCLUSIONS
  The present study showed greater enlargement of the femoral bone tunnel when a bioabsorbable trans-tunnel pin system was used with the medial portal technique when compared to extracortical fixation. These findings confirm that femoral tunnel widening should be considered when RigidFix was used in ACL reconstruction by anteromedial portal technique.
  
  
  METHODS
  III.
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil. ovlopesjr@yahoo.com.br.
authors.forename: Osmar Valadao
authors.initials: OV
authors.lastname: Lopes
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: de Freitas Spinelli
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Luiz Henrique Cunha
authors.initials: LHC
authors.lastname: Leite
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Bruce Quatrin
authors.initials: BQ
authors.lastname: Buzzeto
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Paulo Renato Fernades
authors.initials: PRF
authors.lastname: Saggin
authors.affiliation: Instituto de Ortopedia e Traumatologia de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Kuhn
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects* / Q000295:instrumentation*; D001858:Bone Nails; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D013710:Tendons / Q000637:transplantation; D013977:Tibia / Q000601:surgery; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: ACL reconstruction; Autologous; Bone tunnel enlargement; Hamstrings tendons; Surgical treatment