Description
It has been reported that adding a fibrin clot to an allograft can effectively reduce enlargement of a femoral bone tunnel following ACLR; however, there has been no relevant study quantitatively evaluating the chronological change in the cross-sectional area (CSA) of bone tunnel on multi-reconstructed CT in the double-bundle ACLR (DB-ACLR) with hamstring autograft. The aim of this study was to evaluate whether adding a fibrin clot to an autograft hamstring graft would reduce postoperative tunnel enlargement by means of reconstruction-three-dimensional CT (3D-CT) image analysis.
Twenty-one patients who underwent anatomical DB-ACLR with hamstring autograft with fibrin clot and 24 patients without fibrin clot were included in the study. In the graft preparation, the fibrin clot was placed between two strands of the graft end which was inserted into the femoral tunnel. The CSA of the anteromedial (AM) and the posterolateral (PL) femoral bone tunnels at the aperture and 10 mm from the intra-articular tunnel aperture were measured by 3D-CT images at 1 week and 1 year after surgery.
There were significantly less enlargement in the autograft with fibrin clot group at 10mm from the intra-articular tunnel aperture in AM tunnel, and at both point in PL tunnel, as compared to the only autograft group.
Adding the fibrin clot to the autograft in anatomical DB-ACLR reduced the BTE at 1 year follow up. This effect was particularly effective in the PL tunnel.
