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Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction by Low Accessory Anteromedial Portal Technique: An In Vivo 3D CT Study.

Lee KW, Hwang YS, Chi YJ, Yang DS, Kim HY, Choy WS - Knee Surg Relat Res (2014)

Bottom Line: The mean tibial tunnel position was located at 44.6%±2.5% anterior from the anterior margin and 48.0%±3.0% in medial from the medial margin.The mean femoral tunnel obliquity was 57.7°±6.2° in the sagittal plane and 49.9°±5.6° in the coronal plane.In anatomic single bundle ACL reconstruction, the low anteromedial portal technique can restore accurate position of the native footprint.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.

ABSTRACT

Purpose: Proper femoral tunnel position is important for anatomical reconstruction of the anterior cruciate ligament (ACL). The purpose of this study was to evaluate the positions of femoral and tibial tunnels created using an accessory anteromedial portal technique in single bundle ACL reconstruction.

Materials and methods: The femoral tunnel was targeted at the mid-portion of the ACL bundles. We evaluated postoperative computed tomography scans of 32 patients treated by ACL reconstruction using a free-hand low accessory anteromedial portal technique. On the tibial side, the tunnel position was evaluated using Tsukada's method. On the femoral side, the position was evaluated using 1) the quadrant method, 2) Mochizuki's method, 3) Mochizuki's method, and 4) Takahashi's method. Tunnel obliquity was also evaluated.

Results: The mean tibial tunnel position was located at 44.6%±2.5% anterior from the anterior margin and 48.0%±3.0% in medial from the medial margin. The mean femoral tunnel position was located at the center between the anteromedial and posterolateral bundles: Quadrant method, 26.7%±2.7%/30.0%±2.9%; Watanabe's method, 37.7%±2.5%/26.6%±2.2%; Mochizuki's method, 38.7%±2.7%; Takahashi's method, 21.8%±2.2%. The mean femoral tunnel obliquity was 57.7°±6.2° in the sagittal plane and 49.9°±5.6° in the coronal plane.

Conclusions: In anatomic single bundle ACL reconstruction, the low anteromedial portal technique can restore accurate position of the native footprint. Accurate femoral tunnel position facilitates recovery of stability and decreases graft failure rate.

No MeSH data available.


Related in: MedlinePlus

(A) Coronal obliquity was measured as the angle between the femoral tunnel and a line tangent to the lateral tibial plateau. (B) Sagittal obliquity was measured as the angle between the femoral tunnel and the longitudinal axis of the femur.
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Figure 9: (A) Coronal obliquity was measured as the angle between the femoral tunnel and a line tangent to the lateral tibial plateau. (B) Sagittal obliquity was measured as the angle between the femoral tunnel and the longitudinal axis of the femur.

Mentions: Coronal obliquity was measured as the angle between a line extending through the femoral tunnel and a line tangent to the lateral tibial plateau. Sagittal obliquity was measured as the angle between a line extending through the femoral tunnel and the longitudinal axis of the femur17) (Fig. 9).


Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction by Low Accessory Anteromedial Portal Technique: An In Vivo 3D CT Study.

Lee KW, Hwang YS, Chi YJ, Yang DS, Kim HY, Choy WS - Knee Surg Relat Res (2014)

(A) Coronal obliquity was measured as the angle between the femoral tunnel and a line tangent to the lateral tibial plateau. (B) Sagittal obliquity was measured as the angle between the femoral tunnel and the longitudinal axis of the femur.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061413&req=5

Figure 9: (A) Coronal obliquity was measured as the angle between the femoral tunnel and a line tangent to the lateral tibial plateau. (B) Sagittal obliquity was measured as the angle between the femoral tunnel and the longitudinal axis of the femur.
Mentions: Coronal obliquity was measured as the angle between a line extending through the femoral tunnel and a line tangent to the lateral tibial plateau. Sagittal obliquity was measured as the angle between a line extending through the femoral tunnel and the longitudinal axis of the femur17) (Fig. 9).

Bottom Line: The mean tibial tunnel position was located at 44.6%±2.5% anterior from the anterior margin and 48.0%±3.0% in medial from the medial margin.The mean femoral tunnel obliquity was 57.7°±6.2° in the sagittal plane and 49.9°±5.6° in the coronal plane.In anatomic single bundle ACL reconstruction, the low anteromedial portal technique can restore accurate position of the native footprint.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.

ABSTRACT

Purpose: Proper femoral tunnel position is important for anatomical reconstruction of the anterior cruciate ligament (ACL). The purpose of this study was to evaluate the positions of femoral and tibial tunnels created using an accessory anteromedial portal technique in single bundle ACL reconstruction.

Materials and methods: The femoral tunnel was targeted at the mid-portion of the ACL bundles. We evaluated postoperative computed tomography scans of 32 patients treated by ACL reconstruction using a free-hand low accessory anteromedial portal technique. On the tibial side, the tunnel position was evaluated using Tsukada's method. On the femoral side, the position was evaluated using 1) the quadrant method, 2) Mochizuki's method, 3) Mochizuki's method, and 4) Takahashi's method. Tunnel obliquity was also evaluated.

Results: The mean tibial tunnel position was located at 44.6%±2.5% anterior from the anterior margin and 48.0%±3.0% in medial from the medial margin. The mean femoral tunnel position was located at the center between the anteromedial and posterolateral bundles: Quadrant method, 26.7%±2.7%/30.0%±2.9%; Watanabe's method, 37.7%±2.5%/26.6%±2.2%; Mochizuki's method, 38.7%±2.7%; Takahashi's method, 21.8%±2.2%. The mean femoral tunnel obliquity was 57.7°±6.2° in the sagittal plane and 49.9°±5.6° in the coronal plane.

Conclusions: In anatomic single bundle ACL reconstruction, the low anteromedial portal technique can restore accurate position of the native footprint. Accurate femoral tunnel position facilitates recovery of stability and decreases graft failure rate.

No MeSH data available.


Related in: MedlinePlus