Early tunnel enlargement after arthroscopic ACL reconstructions

Published online: Oct 27 2007

Ender Ugutmen, Korhan Özkan, Melih G├╝ven, Nadir Sener, Faik Altıntas

From the Goztepe Education and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey


The aim of this study was to evaluate the tunnel enlargement phenomenon after ACL reconstructions performed with hamstrings tendons fixed using the cross pin technique. Sixty-two knees in 62 patients were followed for two years to evaluate the possible clinical implications of the femoral and tibial tunnel enlargements noted after ACL reconstruction. The reconstructions were done with hamstring tendons using the cross-pin technique. Evaluation was based on calculated clinical scores (IKDC and Lysholm knee scores) and quantified by KT-1000 measurements. Sagittal and coronal plane computed tomography and conventional radiography were performed 3 days after operation and were repeated after 3 and 6 weeks, 6, 12 and 24 months, to assess early tunnel enlargement. Although it seems that tunnel enlargement after ACL reconstruction has no impact on the clinical results, long-term implications and potential need for revision surgery must be assessed. In this study, tunnel enlargement was noted fairly early after operation and was thought to be related with drilling of the tunnels. A possible solution to this problem may be drilling the tunnels to a diameter 1 mm smaller than the measured graft diameter, then to enlarge the tunnels to the graft diameter with the appropriate tunnel dilator.