scholarly journals Radiological analysis on femoral tunnel positioning between isometric and anatomical reconstructions of the anterior cruciate ligament

2014 ◽  
Vol 49 (2) ◽  
pp. 160-166
Author(s):  
Rodrigo Barreiros Vieira ◽  
Leonardo Augusto de Pinho Tavares ◽  
Rodrigo Campos Pace Lasmar ◽  
Fernando Amaral da Cunha ◽  
Lucas Araujo de Melo Lisboa
Keyword(s):  
Anterior Cruciate Ligament ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Anterior Cruciate ◽  
Tunnel Positioning ◽  
Radiological Analysis

scholarly journals Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction: Anteromedial Portal versus Transtibial Technique—A Randomized Clinical Trial

Joints ◽  
2017 ◽  
Vol 05 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Michele Venosa ◽  
Marco Delcogliano ◽  
Roberto Padua ◽  
Federica Alviti ◽  
Antonio Delcogliano
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Ct Scans ◽  
3D Ct ◽  
Quadrant Method ◽  
Anterior Cruciate ◽  
Tunnel Positioning ◽  
Portal Technique

Purpose The purpose of this study was to investigate, through three-dimensional computed tomography (3D-CT), the accuracy of femoral tunnel positioning in patients undergoing anterior cruciate ligament (ACL) reconstruction, comparing transtibial (TT) and anteromedial (AM) techniques. Methods We evaluated postoperative 3D-CT scans of 26 patients treated with ACL reconstruction with hamstrings autograft using a low accessory AM portal technique and 26 treated with the TT technique. The position of the femoral tunnel center was measured with the quadrant method. Results Using quadrant method on CT scans, femoral tunnels were measured at a mean of 32.2 and 28.1% from the proximal condylar surface (parallel to Blumensaat line) and at a mean of 31.2 and 15.1% from the notch roof (perpendicular to Blumensaat line) for the AM and TT techniques, respectively. Conclusion The AM portal technique provides more anatomical graft placement than TT techniques. Level of Evidence Level I, randomized clinical study.

scholarly journals DEPENDENCE OF THE OUTCOMES OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION ON THE TUNNEL POSITIONING

2018 ◽  
pp. 5-12
Author(s):  
S. A. Bantser ◽  
R. M. Tikhilov ◽  
A. P. Trachuk ◽  
O. E. Bogopol’skiy ◽  
A. V. Rybin ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Subjective Evaluation ◽  
Knee Score ◽  
Lysholm Knee Score ◽  
Anterior Cruciate ◽  
Bone Tunnels ◽  
Tunnel Positioning ◽  
Group 1

Purpose of study: based on the analysis of clinical and radiation data to determine the most favorable positioning of the bone tunnels at different techniques of anterior cruciate ligament (ACL) reconstruction.Study design: retrospective analysis.Patients and methods. Face-to-face and a remote examination was performed in 202 patients at terms from 1.5 to 5 years after primary ACL autoplasty using the graft from the popliteal muscle tendons. All patients were divided into 3 groups depending on the technique of the bone tunnels formation. The patients from the 1stgroup (n=109) were operated on using transtibial technique, from the 2nd(n=52) and 3rd(n=41) groups – using anteromedial technique with the positioning of the femoral tunnel in the central and anteromedial part of ACL attachment, respectively. Bone tunnels positioning was determined using CT with 3D reconstruction. Subjective evaluation was performed by IKDS-2000, KOOS and Lysholm knee score. To assess the tibiofemoral dislocation the anterior drawer, Lachman and pivot shift tests as well as arthrometry (comparison with the healthy side) were performed.Results.In patients from group 1 the tibial tunnel was positioned in the plane of either central or posterolateral part of ACL attachment. In groups 2 and 3 the tunnel was positioned closer to the anteromedial part. In the majority of patients form group 1 the femoral tunnel was positioned in the zone or slightly forwards of the anteromedial part of ACL femoral attachment, in group 2 – in the plane of central or posterolateral part, in group 3 – in the anteromedial part. In patients from the 1st and 2nd groups the subjective evaluation by IKDS-2000, KOOS and Lysholm knee score was comparable and much higher in the 3rdgroup (p<0.05). Objective evaluation showed positive manual tests results in 47 patients (62%) from the 1st group, 19 patients (51%) – 2ndgroup and 4 patients (11%) – 3rdgroup. Arthrometry showed the increase of anteroposterior tibiofemoral dislocation by 3.4±2.6 mm in the 1st group, 3.1±2.7 mm in the 2nd group and 1.2±1.4 mm. Statistical analysis did not reveal significant difference in knee stability between the patients from the 1stand 2ndgroups.Conclusion.Positioning of the femoral tunnel in the plane of anteromedial part of ACL attachment ensures better surgical treatment functional results. In anteromedial technique the use of posterosuperior contour of the lateral femoral condyle as a reference point enables to improve the accuracy of femoral tunnel positioning as well as to minimize the error risk at intraoperative marking.

scholarly journals Correlation of Femoral Tunnel Length with Body Height, Limb Length, and Thigh Length in Indian Patients Undergoing Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 24 (3) ◽  
pp. 286-288
Author(s):  
Ravi Gupta ◽  
Anubhav Malhotra ◽  
Pawan Kumar ◽  
Gladson David Masih
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Body Height ◽  
Limb Length ◽  
Tunnel Length ◽  
Indian Patients ◽  
Anterior Cruciate ◽  
Hamstrings Tendon

Purpose To measure the femoral tunnel length created through a far medial portal and determine its correlation with body height, limb length, and thigh length in 404 Indian patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods 364 male and 40 female Indian patients aged 18 to 51 (mean, 26.8) years underwent ACL reconstruction by a single surgeon using the hamstrings tendon autograft. Their body height, limb length, and thigh length were measured by a single assessor, as was the femoral tunnel length. Results The mean femoral tunnel length was 34.5 mm. It was <30 mm in 28 patients and <25 mm in 2 patients. The correlation coefficients of the femoral tunnel length with body height, limb length, and thigh length were 0.485 (p<0.0001), 0.426 (p<0.0001), and 0.304 (p<0.0001). No patient had posterior wall blowout fracture. Conclusion The femoral tunnel length positively correlated with body height, limb length, and thigh length in 404 Indian patients.

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