All-Epiphyseal Anterior Cruciate Ligament Femoral Tunnel Drilling: Avoiding Injury to the Physis, Lateral Collateral Ligament, Anterolateral Ligament, and Popliteus—A 3-Dimensional Computed Tomography Study

2018 ◽  
Vol 34 (5) ◽  
pp. 1570-1578 ◽  
Author(s):  
Kevin G. Shea ◽  
Peter C. Cannamela ◽  
Peter D. Fabricant ◽  
Elizabeth B. Terhune ◽  
John D. Polousky ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Anterolateral Ligament ◽  
Collateral Ligament ◽  
3 Dimensional ◽  
Anterior Cruciate ◽  
Femoral Tunnel Drilling

scholarly journals Anatomıc femoral tunnel drilling in acl reconstruction without using of an accessory medial portal and evaluation of femoral tunnel positioning using 3-d computed tomography

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Fatih Karaaslan ◽  
Sinan Karaoğlu
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
3D Ct ◽  
Quadrant Method ◽  
Anterior Cruciate ◽  
Femoral Tunnel Drilling ◽  
Transportal Technique

Background and Purpose: Characterization of the insertion site anatomy in anterior cruciate ligament reconstruction has recently received increased attention in the literature, coinciding with a growing interest in anatomic reconstruction. The purpose of this study is to report a modified novel transportal technique to approach the center of anatomical femoral footprint in anterior cruciate ligament (ACL) reconstruction and to investigate the accurate femoral tunnel position with 3-dimensional computed tomography (3D-CT). Materials-Methods: We evaluated 11 patients who underwent primary ACL reconstruction using a modified transportal technique to approach the center of anatomical femoral footprint in single bundle ACL reconstruction with hamstring autograft. Their femoral tunnel positions were investigated with 3D-CT postoperatively according to the quadrant method by three orthopedic surgeons. Results: According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 33,49% ± 5,59% from the proximal condylar surface (parallel to the Blumensaat line) and 32,93% ± 3,82% from the notch roof (perpendicular to the Blumensaat line) with good interobserver (intraclass correlation coefficients [ICC], 0,991and 0,858, respectively with 0,975 – 0,997%95 CI) and intraobserver reliability (ICC, 0.875 and 0.893, respectively with 0,663 – 0,956%95 CI). Conclusions: Our modified transportal technique is anticipated to provide anatomical placement of the femoral tunnel during ACL reconstruction than the former traditional transtibial techniques. This technique is reproducible and also easier to perform than classic transportal technique does not need extra arthroscopic portal. [Figure: see text]

scholarly journals Imaging Findings of Knee Trauma on Magnetic Resonance Imaging

2022 ◽  
Vol 8 (1) ◽  
pp. 12-23
Author(s):  
Poonam Ohri ◽  
Shreeji Goya ◽  
Niveditha C ◽  
Manasi Kohli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Imaging Modality ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Lateral Collateral Ligament ◽  
Cost Effective ◽  
Collateral Ligament ◽  
Imaging Evaluation ◽  
Young Males ◽  
Anterior Cruciate

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.

scholarly journals Computed Tomography Imaging Results of Single Band Anterior Cruciate Ligament Reconstruction: A Retrospective Study Comparing Fixed- and Adjustable-Length Loop Cortical Fixation on the First Day After Surgery

2021 ◽  
Author(s):  
Lifeng Yin ◽  
Hua Zhang ◽  
Junbo Liu ◽  
xingyu zhang ◽  
zhengxing wen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Ct Images ◽  
Graft Fixation ◽  
Bone Preservation ◽  
Anterior Cruciate ◽  
Graft Insertion

Abstract Background: Cortical suspensory femoral fixation is commonly performed for graft fixation of the femur in anterior cruciate ligament (ACL) reconstruction using hamstring tendons. This study aimed to compare the morphology of femoral tunnel and graft insertion between fixed-length loop devices (FLD) and adjustable-length loop devices (ALD) using computed tomography (CT) images on the first day after hamstring ACL reconstruction. Methods: Overall, 94 patients who underwent ACL reconstruction from January 2016 to January 2021 were included. For femoral graft fixation, FLD (Smith & Nephew, ENDOBUTTON) and ALD (DePuy Synthes, Mitek sports medicine, RIGIDLOOP Adjustable cortical system) were used in 56 and 38 patients, respectively (FLD and ALD groups). For evaluation of the morphology of the humeral tunnel and graft depth, CT scans were performed immediately on the first postoperative day. The gap distance between the top of the graft and the socket tunnel end, the length of lateral bone preservation, and the depth of graft insertion were measured on the CT images. Results: The gap distance and bone preservation significantly differed between the two groups (1.90±1.81 mm and 14.35±4.67 mm in ALD groups; 7.08±2.63 mm and 7.35±3.62 mm in FLD groups, respectively; both P values < 0.01). The graft insertion depth did not significantly differ between the groups. Conclusion: The ALD group had a smaller gap distance, better bone preservation, and a similar graft insertion length in the femoral tunnel when compared to the FLD group. Based on these findings, ALD might be better for bone preservation and tunnel utilization in patients with short femoral tunnels. Trial registration: retrospectively registered

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