POSTER ABSTRACTS - ISAKOS

months, and sports activities after 4 months. IKDC
score, Lysholm Test and Tegner score were
recorded as well as the time to resume sport. KT-
2000 arthrometer was also used.
The mean age of the 75 patients was 29.5years
(min.15- max 50 ). 53 patients were male and 22
were female. The right knee was involved in 47
patients and the left in 28.
Associated meniscal lesions found during the
intervention were treated with partial
meniscectomy and were registered.
Results:
In the first group(P.T.) IKDC was in 23 cases
satisfactory, as well in II group(Ham.) while in III
group(Ham+ lat.) 24 patients was satisfactory.
Complete range of motion was obtained in the III
and II group while flexion deficit was observed in
the group I. Tegner score was superposable in the
three group, with 90% of patients that resume
sport at the same level before surgery. Tunnel
enlargment was observed major in the second
group. Subjective evaluation was statistically
better in the third groupwith less time to return to
sport.
I group (PT) had an anterior knee pain: in 12 of 25
patients respect to only 5 and 3 respectively of the
other two groups.
Conclusion:
The three techniques at 5 years has shown
comparable clinical outcome. However range of
motion, subjective evaluation, return to the sport
activity and tunnel enlargement were better in the
group with intra and extraarticular plasty. Patellar
tendon guarantees stability but have higher
incidence of rom deficit and anterior knee pain.
Extraarticular plasty as well as construction with
preservation of tibial insertion allows better
control of associated rotational laxities and of
post.-op. neoligamentization process permitting
good stability avoiding the morbidity of patellar
tendon.
E-poster w/ Standard #432
A Prospective Evaluation of Femoral Tunnel
Widening in Hamstring ACL Reconstructions.
Guillermo R. Arce, Buenos Aires, ARGENTINA,
Presenter
Pablo Lacroze, Buenos Aires, ARGENTINA
Juan Pablo Previgliano, Buenos Aires, ARGENTINA
Eduardo Humberto Costanza, Buenos Aires,
ARGENTINA
Matias Canete, Buenos Aires, ARGENTINA
IADT, Buenos Aires, ARGENTINA
Backgound: Isometric position of the femoral
tunnel is the key of success in ACL reconstruction
procedures. Tunnel enlargement may jeopardize
long term results and revision surgery.
Objective: The purpose of this study was to
prospectively evaluate the incidence of femoral
tunnel enlargement (FTE) in two different femoral
fixation devices and its influence in the clinical
outcome.
Method: Eighty patients were prospectively
selected for quadrupled hamstring ACL
reconstructions. Group A was fixed with a
titanium cross pin ( Arthrex, Transfix) with 30 mm
distance between fixation device and the
Blumensaat´s line. In Group B , the hamstring
graft was fixed with two bioabsorbable cross pins (
Mitek, Rigid Fix) and the distance to anatomical
fixation was 13 mm. Mean age, sex, DJD changes
and tibial fixation devices were the same in both
groups. The operated knee was radiographed the
day after surgery, and at 6 , 12 and 24 months
post-reconstruction. The average femoral tunnel
diameter was measured on AP and lateral images.
The tunnel diameter was calculated and compared
to the initial diameter recorded from the operative
drill size. The clinical outcome was evaluated
using IKDC score and KT1000 Arthrometer
measurements.
Results: Sixty six patients were available for a 2
year follow up period ( Group A: 34; Group B: 32).
No significant tunnel enlargement was found in
the immediate postoperative X-rays in either
groups. After 6 months, the X rays demonstrated a
62% larger average diameter in group A and 49 %
in group B. At the one year measurements the
femoral aperture diameter decreased 24 % in
group A and 21 % in group B. No differences were
recorded at the 24 months evaluation. Tunnel
widening did not influence clinical outcome over a
2 year period.
Discussion & Conclusions: FTE does not influence
the late results of ACL reconstructions. No
significant differences were found between the
herein femoral fixation devices but fixations
nearer the anatomic ACL femoral footprint seems
to have less radiographic femoral tunnel
enlargement.