title: HOW CAN BONE TUNNEL ENLARGEMENT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SURGERY BE MEASURED? DESCRIPTION OF A TECHNIQUE.
abstract: To assess the presence of tibial bone tunnel enlargement after surgery to reconstruct the anterior cruciate ligament using quadruple flexor tendon grafts, and to propose a new technique for its measurement.
  
  
  METHODS
  The study involved 25 patients aged 18-43 years over a six-month period. The assessment was based on radiographs taken immediately postoperatively and in the third and sixth months of evolution after operations to reconstruct the anterior cruciate ligament using grafts from the tendons of the semitendinosus and gracilis muscles, fixed in the femur with a transverse metal screw and in the tibia with an interference screw. The radiographs were evaluated in terms of the relative value between the diameter of the tunnel and the bone, both at 2 cm below the medial tibial condyle.
  
  
  RESULTS
  There were significant increases in tunnel diameters: 20.56% for radiographs in anteroposterior view and 26.48% in lateral view. Enlargement was present in 48% of anteroposterior and lateral radiographs, but was present in both views in only 16% of the cases.
  
  
  CONCLUSIONS
  Bone tunnel enlargement is a phenomenon found in the first months after surgery to reconstruct the anterior cruciate ligament. The measurement technique proposed in this study was sufficient to detect it.
authors.affiliation: MSc on Orthopedics and Traumatology from the School of Medical Sciences, Santa Casa de São Paulo. Trainee in the Sports Traumatology Group, Santa Casa de Sao Paulo, São Paulo, Brazil.
authors.forename: Adriano Barros de
authors.initials: AB
authors.lastname: Aguiar Leonardi
authors.affiliation: PhD. Assistant Professor and Head of the Knee Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo (DOT-FCMSCSP), São Paulo, Brazil.
authors.forename: Nilson Roberto
authors.initials: NR
authors.lastname: Severino
authors.affiliation: Head of the Sports Traumatology Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo (DOT-FCMSCSP), Sao Paulo, Brazil.
authors.forename: Aires Duarte
authors.initials: AD
authors.lastname: Junior
keywords: Anterior Cruciate Ligament/surgery; Femur; Muscles; Reconstructive Surgical Procedures; Tendons; Tibia