Three-dimensional reconstruction with dual-source computed tomography for evaluating graft deformation and bone tunnel position following reconstruction of the anterior cruciate ligament

Objective: Considering the limitations of MRI and X-ray and few studies on the use of dual-source computed tomography (DSCT) in anterior cruciate ligament (ACL) reconstruction are limited, this study explored the clinical application of DSCT for three-dimensional reconstruction of graft deformation and bone tunnel position images following ACL reconstruction.Methods: The data of 123 patients who underwent single-bundle ACL reconstruction under arthroscopy from January 2017 to October 2021 were retrieved. Two weeks after surgery, DSCT was used to assess graft defor-mation and tunnel widening. Based on the positions of ACL graft deformation and bone tunnel, the patients were divided into a collision group (n = 35), posterior group (n = 37) and satisfactory group (n = 51). The groups were compared in terms of the relative position of the central point of the femoral tunnel (FX, FY) and tibial tunnel (TX, TY), the straight-line distances of the grafts (L), the sagittal plane angle (z alpha), and the coronal plane angle (z3) between the two bone tunnels.Results: Tx, Ty, z alpha and z3 were significantly different among the three groups, while no difference in Fx, Fy and L were observed. Tx, Ty and z alpha were identified as independent risk factors for collisions between the graft and intercondylar notch. Ty and z alpha were independent risk factors for posterior deviation of tibial tunnel position.Conclusion: DSCT demonstrated promising clinical applicability to evaluate graft deformation and bone tunnel position after reconstruction of ACL and could guide preoperative positioning and postoperative evaluation.