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J Knee Surg 2023; 36(08): 820-826
DOI: 10.1055/s-0042-1743234
Original Article

Larger Prior Tibial Tunnel Size Is Associated with Increased Failure Risk following Revision Anterior Cruciate Ligament Reconstruction

Jacy Leon
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
David C. Flanigan
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Matthew Colatruglio
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Benjamin Ormseth
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Sean Fitzpatrick
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Robert A. Duerr
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Christopher C. Kaeding
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
,
Robert A. Magnussen
1   Department of Orthopaedics, OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio
› Author Affiliations
Funding None.
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Abstract

We hypothesize that larger prior tunnel size is associated with an increased risk of failure of single-stage revision anterior cruciate ligament reconstruction (ACLR) as defined by the performance of a re-revision (third) ACLR on the index knee. Retrospective review identified 244 patients who underwent single-stage revision ACLR at a single center with available preoperative radiographs. Patient and surgical factors were extracted by chart review. The maximum diameter of the tibial tunnel was measured on lateral radiographs and the maximum diameter of the femoral tunnel was measured on anteroposterior radiographs. Record review and follow-up phone calls were used to identify failure of the revision surgery as defined by re-revision ACLR on the index knee. One hundred and seventy-one patients (70%) were reviewed with a mean of 3.9 years follow-up. Overall, 23 patients (13.4%) underwent re-revision surgery. Mean tibial tunnel size was 12.6 ± 2.8 mm (range: 5.7–26.9 mm) and mean femoral tunnel size was 11.7 ± 2.8 mm (range: 6.0–23.0 mm). Re-revision risk increased with tibial tunnel size. Tibial tunnels 11 mm and under had a re-revision risk of 4.2%, while tunnels > 11 mm had a risk of 17.1% (relative risk: 4.1, p = 0.025). No significant association between femoral tunnel size and re-revision risk was noted. Patients with prior tibial tunnels > 11mm in diameter at revision surgery had significantly increased risk of re-revision ACLR. Further studies are needed to explore the relationship between prior tunnel size and outcomes of revision ACLR.

Keywords

ACL reconstruction - tibial tunnel - single-stage revision - re-revision

Ethical Approval

This study was approved by the Biomedical Institutional Research Board of The Ohio State University, (Protocol 2016H0444).




Publication History

Received: 15 August 2021

Accepted: 09 January 2022

Article published online:
03 March 2022

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