Open AccessMeasurements of bone tunnel size in anterior cruciate ligament reconstruction: 2D versus 3D computed tomography model
Author(s) -
Crespo Bernardo,
Aga Cathrine,
Wilson Katharine J,
Pomeroy Shan M,
LaPrade Robert F,
Engebretsen Lars,
Wijdicks Coen A
Publication year - 2014
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-014-0002-0
Subject(s) - anterior cruciate ligament , drill , transverse plane , computed tomography , anterior cruciate ligament reconstruction , tomography , correlation coefficient , medicine , cylinder , orthopedic surgery , nuclear medicine , biomedical engineering , mathematics , materials science , radiology , surgery , geometry , statistics , metallurgy
Background Revision anterior cruciate ligament (ACL) reconstruction requires a precise evaluation of previous tunnel locations and diameters. Enlargement of the tunnels, despite not usually affecting primary reconstruction outcomes, plays an important role in revision ACL management. Three dimensional (3D) computed tomography (CT) models are reported to be the most accurate method for identifying the tunnel position and possible conflicts with a revision tunnel placement. However, the ability of 3D CT to measure the tunnel size is still not proven. The goal of this study was to evaluate the ability of measuring the size of the bone tunnels in ACL reconstructed knees with 3D CT compared to the traditional two dimensional (2D) CT method. Methods Twenty‐four patients had CT scans performed immediately following ACL reconstruction surgery. Their femoral tunnels size were measured by a standard 2D CT measurement and then compared with three novel 3D CT measuring methods: the best transverse section method, the best fit cylinder method and the wall thickness method. The drill size used during surgery was used as a control measure for the tunnel width. Intra‐class correlation coefficients were obtained. Results The intra‐class correlation coefficient and respective 95% confidence interval range (ICC [95%CI]) for the three methods compared with the drill sizes were 0.899 [0.811‐0.947] for the best transverse section method, 0.745 [0.553‐0.862] for the best fit cylinder method, −0.004 [−0.081 to −0.12] for the wall thickness method and 0.922 [0.713‐0.97] for the 2D CT method. The mean differences compared to the drill size were 0.02 mm for the best fit transverse section method, 0.01 mm for the best fit cylinder diameter method, 3.34 mm for the wall thickness method and 0.29 mm for the 2D CT method. The intra‐rater agreement (ICC [95%CI]) was excellent for the best transverse section method 0.999 [0.998‐0.999] and the 2D CT method 0.969 [0.941‐0.984]. Conclusions The 3D best transverse section method presented a high correlation to the drill sizes and high intra‐rater agreement, and was the best method for ACL tunnel evaluation in a 3D CT based model.