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Author Topic: Bone tunnel widening?  (Read 2576 times)

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Offline pt striker

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Bone tunnel widening?
« on: October 22, 2007, 11:01:42 PM »

Howdy KneeGeeks

I'm 16 months post ACLR (patella tendon allograft) and have had some trouble with swelling when I use the knee hard (ie when backpacking over rough terrain, or playing lots of soccer). Anyway, my orthopedist decided to take an X-ray, and in it he said he noticed some widening of the tibial bone tunnel. Anyone have any experience with this or knowledge they can share?

Many thanks!

pt

Offline cmvsm

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Re: Bone tunnel widening?
« Reply #1 on: October 23, 2007, 10:40:21 AM »
I think that there are a lot of variables when it comes to tunnel widening (i.e. graft method, securing method, genetics, etc.) and from what I've read, there is not a lot of definitive information yet as to why it happens. Apparently, it happens to those that have hamstring grafts more often than other types of grafts, and more often in those who have bio-absorbable screws versus those who have metal screws.
ACLr and Menisectomy on 7/18/07 - Allograft

Offline mc_1_2_3

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Re: Bone tunnel widening?
« Reply #2 on: October 24, 2007, 05:03:12 AM »
Hello.  What kind of screws were used?  I am 13 days post-op on my third ACL surgery.  This time I also had LCL replaced and MCL repaired, which were the likely cause of first 2 failures.  Anyway,  I have had allograft for all surgeries, with bone absorbable screws.  No trouble with tunnels at all.  In fact, the xray 2 months ago showed no evidence of the screws which inserted 2 years ago.  Hate to say it, but you may be looking at more surgery.  The tunnels should not widen and should in fact fill in with new bone.  I am not a doctor so your OS will surely be able to give you a clear answer on what will need to be done.

Good luck,
Mark

Offline pt striker

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Re: Bone tunnel widening?
« Reply #3 on: October 29, 2007, 08:16:26 PM »

I had a metal screw in the femur, bioabsorbable in the tibia. I just did a bit of reading and located a comprehensive study on bone tunnel widening in which bioabsorbable screws were associated with more severe bone tunnel widening. The authors could say why for sure, but speculated it was something to do with cytokines and causing osteolysis (ie dissolving of bone)...hmm, where's my medical degree? 

Anyway, I guess the fact that no one seems to know much about it means its not that big a problem...(?) Until, of course, you need a revision and there's nothing to drill into!

pt


Offline mc_1_2_3

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Re: Bone tunnel widening?
« Reply #4 on: October 29, 2007, 09:29:52 PM »
Actually, I believe it is a problem, possibly a big problem.  Tunnel widening means that there are gaps between the ligament and the bone tunnel, the tunnel is getting bigger instead of filling in.  The bone isn't growing to fill in.
When  your surgeon told you had the widening, did he say what he was going to do about it?  I think something will have to be done if it doesn't remedy itself.

Good luck

Offline celinenj03

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Re: Bone tunnel widening?
« Reply #5 on: January 16, 2008, 09:37:16 PM »
I think I had the opposite happen to me and I had too much fill in of bone.
Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)















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