Does an accessory tibial fixation has any impact on tunnel diameter or functional outcome in conventional ACL reconstruction

Purpose Evaluation of tunnel widening and functional outcome parameters in conventional ACL reconstruction with and without accessory tibial fixation. Methods 43 patients who underwent hamstring tendon ACL reconstruction were assessed retrospectively with a CT scan for tunnel widening and were compared to intra-operative drilling diameter. The functional assessment comprised of 2000 IKDC subjective knee score, Lysholm score, pivot shift test, and side-to-side difference in knee laxity. Results 22 patients without accessory tibial fixation (Group A) and 21 patients with accessory tibial fixation (Group B) with a minimum follow-up of 29 months were compared. The clinical outcome parameters were comparable between the groups. On the rank-sum test, the percentage change in tunnel diameter did not exhibit any significant difference in the articular(F1) and middle portion(F2) of the femoral socket (P = 0.39 and 0.86 for F1 and F2, respectively) as well as in the articular(T1) and middle portion(T2) of tibial tunnel (P = 0.07 and 0.87 for T1 and T2, respectively). 4 out of 21 Group B patients complained about hardware prominence. Conclusion Accessory tibial fixation has no benefits in terms of tunnel widening and clinical outcomes. Rather it may lead to hardware prominence. Level of evidence: III