title: Anterior cruciate ligament reconstruction tunnel size: causes of tunnel enlargement and implications for single versus two-stage revision reconstruction.
abstract: Anterior cruciate ligament (ACL) reconstructions have increased over the past 25 years. The increased incidence of ACL reconstructions has translated into a larger number of graft failures and revision ACL procedures. It is important to understand the causes of graft failure when evaluating for a revision ACL reconstruction and to appreciate changes in tunnel anatomy over time prior to planning revision surgery. In this manuscript, tunnel size for ACL reconstruction and implications for single-stage versus two-stage revision ACL reconstruction will be discussed, as well as causes of tunnel enlargement, including mechanical and biological factors.
authors.affiliation: Radiology Resident PGY-5, Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL, USA. MagdaRizer@gmail.com.
authors.forename: Magda
authors.initials: M
authors.lastname: Rizer
authors.affiliation: Radiology Resident PGY-2, Department of Radiology, University of Miami /Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Gregory Brian
authors.initials: GB
authors.lastname: Foremny
authors.affiliation: Orthopedic Surgery Resident PGY-2, Department of Orthopaedics, University of Miami /Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Augustus
authors.initials: A
authors.lastname: Rush
authors.affiliation: Section of Musculoskeletal Imaging, Department of Radiology and Imaging Sciences, Emory Healthcare, Atlanta, GA, USA.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Singer
authors.affiliation: Department of Orthopaedics, Orthopaedic Surgery Residency Program, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Baraga
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics, Department of Biomedical Engineering, Department of Kinesiology and Sports Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Lee D
authors.initials: LD
authors.lastname: Kaplan
authors.affiliation: Sports Medicine Imaging, Section of Musculoskeletal Imaging, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Jose
mesh_terms: D059549:Anterior Cruciate Ligament Reconstruction; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D012086:Reoperation; D017211:Treatment Failure
keywords: Anterior cruciate ligament reconstruction; Anterior cruciate ligament revision; Graft failure; Radiographic findings; Single-stage revision; Tunnel enlargement; Two-stage revision