The effects of tibial tunnel placement and roofplasty on reconstructed anterior cruciate ligament knees

1995 ◽  
Vol 11 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Takeshi Muneta ◽  
Haruyasu Yamamoto ◽  
Toshiro Ishibashi ◽  
Shintaro Asahina ◽  
Shunich Murakami ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Placement ◽  
Anterior Cruciate

The Importance of Tibial Tunnel Placement in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

2013 ◽  
Vol 29 (6) ◽  
pp. 1072-1078 ◽  
Author(s):  
Kazuhisa Hatayama ◽  
Masanori Terauchi ◽  
Kenichi Saito ◽  
Hiroshi Higuchi ◽  
Shinya Yanagisawa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Double Bundle ◽  
Tunnel Placement ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Comparison of Anterior Cruciate Ligament Graft Isometry between Paired Femoral and Tibial Tunnels

2017 ◽  
Vol 30 (09) ◽  
pp. 960-964 ◽  
Author(s):  
E. Cain ◽  
Marcus Biggers ◽  
Benton Emblom ◽  
Jeffrey Dugas ◽  
David Beason
Keyword(s):  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Placement ◽  
Posterior Aspect ◽  
Acl Graft ◽  
Posterior Tibial ◽  
Anterior Cruciate

AbstractAccurate tunnel placement is important for a successful anterior cruciate ligament (ACL) reconstruction. Controversy exists concerning the preferred method of femoral tunnel preparation, with proponents of both medial portal and transtibial drilling techniques. Current ACL literature suggests that placement of the femoral ACL attachment site posterior or “low” in the ACL footprint leads to more anatomically correct ACL mechanics and better rotational control. There is limited literature focusing on ACL graft displacement through knee range of motion based on specific paired placement of femoral and tibial tunnels. Our purpose was to assess ACL isometry between multiple combinations of femoral and tibial tunnels. We hypothesized that placement of the graft at the posterior aspect of the ACL footprint on the femur would be significantly less isometric and lead to more graft displacement as compared with central or anterior placement. The ACL of matched pairs of cadaveric knees was arthroscopically debrided while leaving the soft tissue footprint on the femur and tibia intact. One knee from each pair underwent notchplasty. In all knees, three femoral and three tibial tunnels were created at the anterior, central, and posterior aspects of the ACL footprint. A suture was passed through each tunnel combination (nine potential pairs), and the change in isometry was measured throughout full knee range of motion. Placement of the femoral tunnel along the posterior aspect of the ACL footprint was less isometric compared with a central or anterior position in the femoral footprint. Placement of a posterior tibial tunnel also led to decreased isometry, but tibial tunnel placement affected isometry to a lesser extent than femoral tunnel placement. The combination of a posterior femoral and posterior tibial tunnel resulted in greater than 1 cm of graft excursion from full flexion to extension. Placement of ACL tunnels at anisometric sites may adversely affect the mechanical properties and behavior of the ACL graft, resulting in either graft laxity in flexion or overconstraint and loss of extension.

Evaluating the Accuracy of Tibial Tunnel Placement After Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 47 (13) ◽  
pp. 3187-3194 ◽  
Author(s):  
Christopher Pedneault ◽  
Carl Laverdière ◽  
Adam Hart ◽  
Mathieu Boily ◽  
Mark Burman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
3D Mri ◽  
Tunnel Placement ◽  
Anatomic Acl Reconstruction ◽  
Imaging Protocol ◽  
Tibial Footprint ◽  
Anterior Cruciate

Background: Anatomic anterior cruciate ligament (ACL) reconstruction improves knee kinematics and joint stability in symptomatic patients who have ACL deficiency. Despite a concerted effort to place the graft within the ACL’s native attachment sites, the accuracy of tunnel placement using contemporary techniques is not well established. Purpose: To use 3-dimensional magnetic resonance imaging (3D MRI) to prospectively evaluate the accuracy of tibial tunnel placement after anatomic ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Forty patients with symptomatic, ACL-deficient knees were prospectively enrolled in the study and underwent 3D MRI of both their injured and uninjured knees before and after surgery through use of a validated imaging protocol. The root ligament of the anterior horn of the lateral meniscus was used as a radiographic reference, and the center of the reconstructed graft was compared with that of the contralateral normal knee. The tunnel angles and intra-articular graft angles were also measured, as was the percentage overlap between the native tibial footprint and tibial tunnel. Results: The reconstructed tibial footprint was placed at a mean ± SD of 2.14 ± 2.45 mm ( P < .001) medial and 5.11 ± 3.57 mm ( P < .001) posterior to the native ACL footprint. The mean distance between the center of the native and reconstructed ACL at the tibial attachment site was 6.24 mm. Of the 40 patients, 18 patients had a tibial tunnel that overlapped more than 50% of the native footprint, and 10 patients had maximal (100%) overlap. Further, 22 of the 40 patients had less than 50% overlap with the native footprint, and in 12 patients the footprint was missing completely. Conclusion: Despite the use of contemporary surgical techniques to perform anatomic ACL reconstruction, a significant positioning error in tibial tunnel placement remains.

Tibial Tunnel Placement in Anterior Cruciate Ligament Reconstructions and Graft Impingement

1992 ◽  
Vol &NA; (283) ◽  
pp. 187???195 ◽  
Author(s):  
MAJ STEPHEN M. HOWELL ◽  
JAMES A. CLARK
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Placement ◽  
Anterior Cruciate
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