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Anatomical Single-bundle Anterior Cruciate Ligament Reconstruction Using a Freehand Transtibial Technique.

Nha KW, Han JH, Kwon JH, Kang KW, Park HJ, Song JG - Knee Surg Relat Res (2015)

Bottom Line: The mean Lysholm score improved from 68.2±12.7 points preoperatively to 89.2±8.2 points at final follow-up.None of the patients had a positive pivot shift test, anterior drawer test and Lachman test at final follow-up.The anatomical position of the femoral tunnel was confirmed on 3D CT scans.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

ABSTRACT

Purpose: In anatomical single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, the traditional transtibial approach can limit anatomical placement of the femoral tunnel.

Surgical technique: We present a novel three-point freehand technique that allows for anatomic SB ACL reconstruction with the transtibial technique.

Materials and methods: Between January 2012 and December 2012, 55 ACL reconstructions were performed using the three-point freehand technique. All the patients were followed for a minimum of 12 months post-operatively. Clinical evaluation was done using the Lysholm score and International Knee Documentation Committee (IKDC) grade. All patients were analyzed by 3-dimensional computed tomography (3D CT) at 1 week after surgery.

Results: The mean Lysholm score improved from 68.2±12.7 points preoperatively to 89.2±8.2 points at final follow-up. At final follow-up, the IKDC grade was normal in 42 patients and nearly normal in 13 patients. None of the patients had a positive pivot shift test, anterior drawer test and Lachman test at final follow-up. The anatomical position of the femoral tunnel was confirmed on 3D CT scans.

Conclusions: The three-point freehand technique for SB transtibial ACL reconstruction is a simple, anatomic technique showing good clinical results.

No MeSH data available.


Femoral tunnel position by the quadrant method in a 3-dimensional computed tomography model. t: line parallel to the Blumensaat's line, h: line perpendicular to the Blumensaat's line.
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Figure 3: Femoral tunnel position by the quadrant method in a 3-dimensional computed tomography model. t: line parallel to the Blumensaat's line, h: line perpendicular to the Blumensaat's line.

Mentions: Between January 2012 and December 2012, 55 ACL reconstructions were performed using the three-point freehand technique. All the patients were followed for a minimum of 12 months postoperatively. The patients' average age was 35.6 years (range, 19 to 46 years). The mean follow-up period was 14 months (range, 12 to 23 months) (Table 1). Evaluation of clinical results was done using the Lysholm score and objective International Knee Documentation Committee (IKDC) grade. All patients underwent 3D CT scanning (Aquilion One; Toshiba Medical Systems Cor., Otawara, Japan) at 1 week after surgery. The created 3D CT images were aligned with the femoral tunnels to perform analysis according to the quadrant method suggested by Bernard et al.13) using PACS View (PACS; Marotech Inc., Seoul, Korea) (Fig. 3).


Anatomical Single-bundle Anterior Cruciate Ligament Reconstruction Using a Freehand Transtibial Technique.

Nha KW, Han JH, Kwon JH, Kang KW, Park HJ, Song JG - Knee Surg Relat Res (2015)

Femoral tunnel position by the quadrant method in a 3-dimensional computed tomography model. t: line parallel to the Blumensaat's line, h: line perpendicular to the Blumensaat's line.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4458482&req=5

Figure 3: Femoral tunnel position by the quadrant method in a 3-dimensional computed tomography model. t: line parallel to the Blumensaat's line, h: line perpendicular to the Blumensaat's line.
Mentions: Between January 2012 and December 2012, 55 ACL reconstructions were performed using the three-point freehand technique. All the patients were followed for a minimum of 12 months postoperatively. The patients' average age was 35.6 years (range, 19 to 46 years). The mean follow-up period was 14 months (range, 12 to 23 months) (Table 1). Evaluation of clinical results was done using the Lysholm score and objective International Knee Documentation Committee (IKDC) grade. All patients underwent 3D CT scanning (Aquilion One; Toshiba Medical Systems Cor., Otawara, Japan) at 1 week after surgery. The created 3D CT images were aligned with the femoral tunnels to perform analysis according to the quadrant method suggested by Bernard et al.13) using PACS View (PACS; Marotech Inc., Seoul, Korea) (Fig. 3).

Bottom Line: The mean Lysholm score improved from 68.2±12.7 points preoperatively to 89.2±8.2 points at final follow-up.None of the patients had a positive pivot shift test, anterior drawer test and Lachman test at final follow-up.The anatomical position of the femoral tunnel was confirmed on 3D CT scans.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

ABSTRACT

Purpose: In anatomical single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, the traditional transtibial approach can limit anatomical placement of the femoral tunnel.

Surgical technique: We present a novel three-point freehand technique that allows for anatomic SB ACL reconstruction with the transtibial technique.

Materials and methods: Between January 2012 and December 2012, 55 ACL reconstructions were performed using the three-point freehand technique. All the patients were followed for a minimum of 12 months post-operatively. Clinical evaluation was done using the Lysholm score and International Knee Documentation Committee (IKDC) grade. All patients were analyzed by 3-dimensional computed tomography (3D CT) at 1 week after surgery.

Results: The mean Lysholm score improved from 68.2±12.7 points preoperatively to 89.2±8.2 points at final follow-up. At final follow-up, the IKDC grade was normal in 42 patients and nearly normal in 13 patients. None of the patients had a positive pivot shift test, anterior drawer test and Lachman test at final follow-up. The anatomical position of the femoral tunnel was confirmed on 3D CT scans.

Conclusions: The three-point freehand technique for SB transtibial ACL reconstruction is a simple, anatomic technique showing good clinical results.

No MeSH data available.