Tunnel osteolysis post-ACL reconstruction: a systematic review examining select diagnostic modalities, treatment options and rehabilitation protocols

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Ramandeep BhullarOlufemi R Ayeni

Abstract

The purpose of this systematic review was to (1) identify the optimal diagnostic modality for tunnel widening in skeletally mature patients; (2) identify potentially modifiable risk factors for tunnel widening, such as graft type, and (3) determine what elements of a post-operative rehabilitation program exert the most influence on TW. The electronic databases MEDLINE, EMBASE, PubMed, and Cochrane Library were searched from database inception to January 2018. Studies that discussed tunnel widening following anterior cruciate ligament reconstruction (ACLR) of skeletally mature patients and written in English were included. Descriptive statistics, such as means, ranges, and measures of variance (e.g. standard deviations, 95% confidence intervals (CI)) are presented where applicable. 103 studies (6,383 patients) were included. Plain radiographs were the most commonly used diagnostic modality, but radiographs on average required 10 months longer than CT and 2 months longer on average than MRI to diagnose tunnel widening after ACLR. Although CT was the least commonly used modality, it was the shortest time to diagnose tunnel widening at 9.5 months after ACLR. Bone-patellar tendon-bone (BPTB) allograft had the largest average tunnel ...Continue Reading

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Citations

Aug 15, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Siva ThangarajuFrank Martetschläger
Apr 27, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Daniel P BertholdAugustus D Mazzocca
Mar 11, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Tristan DuguayAlexandre Hardy

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