Axial Angle May Affect Femoral Tunnel Length in ACL Reconstruction

2011 ◽  
Vol 1 (1) ◽  
Author(s):  
Mark D. Miller
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Tunnel Length ◽  
Axial Angle

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.

scholarly journals Can an Anatomical ACL Reconstruction be Performed with Two Standart Portals?

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Cem Coşkun Avcı ◽  
Hüseyin Koca ◽  
Necdet Sağlam ◽  
Tuhan Kurtulmuş ◽  
Gürsel Saka
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Coronal Plane ◽  
Radiographic Measurement ◽  
Single Bundle ◽  
Anteromedial Portal ◽  
Tunnel Placement ◽  
Tunnel Length ◽  
Femoral Tunnel Drilling ◽  
Tunnel Angle

Objectives: Recent studies have demonstrated that ACL reconstruction via anatomic tunnel placement would provide superior stability. In order to achieve an anatomic femoral tunnel, accessory anteromedial portal (three-portal tecnique) and medial Hoffa excision is necessary. Femoral tunnel drilling through a far anteromedial portal facilitates anatomic tunnel placement but can also results in shorter femoral tunnel and articular cartilage damage of the medial femoral condyle. Our purpose in this study was to evaluate whether an anatomic single bundle ACL reconstruction can be performed with the use of the two standart portals (anteromedial and anterolateral). Methods: Fifty seven patient underwent single bundle ACL reconstruction in our clinic between 2012-2014, with the use of either standart portals or three-portal tecnique. We measured the tunnel length and and femoral tunnel angle in coronal plane to assess the reconstruction. Two portals group included thirty -three patients (twenty-nine males, four females with a mean age of 27±2,4) and three portals group included twenty–four patients (twenty-three males, one female with a mean age of 26±2,9). All patients were evaluated with computerized tomography (CT) scans to determine femoral tunnel length and obliquity. Tunnel length was defined as the distance between the intra-articular and extra-articular tunnel apertures in coronal sections. Femoral tunnel angle was measured in the coronal plane on AP radiographs of the knee. For statistical analysis, student t test was used for normal categorical data. A p value of <0.05 was considered significant. Results: Average tunnel length was 44.2 ±6.8 mm (range: 32.6-55.2) in two portals group and 32.8±7.9 mm (range: 24.8-43.2) in three portal group. The average tunnel length in three portal group was significantly smaller (p<0.05). According to radiographic measurement on the AP view, femoral tunnel angle averaged 48.20±7.10 (range:38.60-56.10) in two portals group and 47.20±6,30 (range: 39.40-55.20) in three portals group. This difference was not statistically significant (p=0.2). Conclusion: Femoral tunnels drilled with standart two-portal tecnique were longer than three-portal tecnique. However, femoral tunnel angles was not different in two groups. Tunnel characteristic in terms of anatomic position was obtained with standart two-portal tecnique. Consequently, femoral tunnels can be placed anatomically with standart portals.

scholarly journals Three-Dimensional Reconstruction Computed Tomography Evaluation of the Tunnel Location and Angle during Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0009
Author(s):  
Sang Hak Lee ◽  
Kyung Hk Yoon ◽  
Chan Il Bae
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Posterior Wall ◽  
Width Ratio ◽  
Single Bundle ◽  
Tunnel Length ◽  
Tunnel Position ◽  
The Mean

Purpose: Tibial tunnel-independent drilling has attracted increased interest in recent years for anatomic anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare the geometry and position of the femoral tunnel between the anteromedial portal (AMP) and outside-in (OI) techniques after anatomic single-bundle ACL reconstruction. Methods: We prospectively evaluated 82 patients undergoing single-bundle ACL reconstruction with hamstring tendon autografts using either the AMP (n=40) or OI (n=42) technique. The locations of the tibial and femoral tunnel apertures were assessed by immediate postoperative 3-dimensional computed tomography (3D CT) imaging with OsiriX imaging software. The femoral graft bending angle, femoral tunnel aperture shape (height/width ratio), femoral tunnel length, and posterior wall breakage were also measured. Results: The two techniques did not differ significantly in the femoral tunnel position perpendicular to the Blumensaat line. However, the mean femoral tunnel position parallel to the Blumensaat line was more caudally positioned in the AMP group than in the OI group (P=0.025) The two groups did not differ significantly in tibial tunnel position. The mean femoral tunnel length did not differ between the AMP (36.1±0.33 mm) and OI groups (35.6±0.37 mm; P=0.548) The mean femoral graft angle in the OI group (99.6°±7.1°) was significantly more acute than that of the AMP group (108.9°±10.2°) (p < 0.0001). The mean height/width ratio of the AMP group (1.21±0.20) was significantly more ellipsoidal than that of the OI group (1.07±0.09) (p < 0.0001). Posterior wall breakage was detected in 3 cases (7.5%), all in the AMP group. Conclusions: After single-bundle anatomic ACL reconstruction, 3D CT showed a significantly shallower femoral tunnel in the AMP group than in the OI group. The AMP group had a more ellipsoidal femoral tunnel with a risk of posterior wall breakage than the OI group. The OI group showed a more acute bending angle of the femoral tunnel than the AMP group. [Figure: see text][Figure: see text]

Femoral tunnel length in anatomical single-bundle ACL reconstruction is correlated with height, weight, and knee bony morphology

2018 ◽  
Vol 27 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Takanori Iriuchishima ◽  
Bunsei Goto ◽  
Tatsumasa Okano ◽  
Keinosuke Ryu ◽  
Freddie H. Fu
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Single Bundle ◽  
Tunnel Length ◽  
Bony Morphology

Sagittal femoral condyle morphology correlates with femoral tunnel length in anatomical single bundle ACL reconstruction

2017 ◽  
Author(s):  
Takanori Iriuchishima ◽  
Freddie H. Fu ◽  
Keinosuke Ryu ◽  
Makoto Suruga ◽  
Yoshiyuki Yahagi ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Femoral Condyle ◽  
Single Bundle ◽  
Tunnel Length

scholarly journals The use of an Accesory Medial Portal in Anatomic ACL Reconstruction a Prospective Ct- Study

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0022
Author(s):  
Vasileios Theodore Chouliaras ◽  
Konstantinos Bellos ◽  
Dimitris Flevas ◽  
Vasiliki Tsaggou ◽  
George Kavalaris
Keyword(s):  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Study Groups ◽  
Tunnel Length ◽  
Anatomic Acl Reconstruction ◽  
Oblique Position ◽  
Anterior Cruciate ◽  
Level Of Significance ◽  
Group B

Objectives The purpose of this study was to evaluate if any differences exist regarding the position and the length of the femoral tunnel between the anterior cruciate ligament (ACL) reconstruction (ACLR) with the use of an accessory medial portal and the ACLR with no use of accessory medial portal using computed tomography (CT) imaging. Methods Twenty-five consecutive patients that underwent ACLR with the aid of an accessory medial portal (Group A) and 25 ACL-reconstructed (ACL-R) patients with no use of the accessory medial portal (Group B) formed the two study groups. The femoral tunnel angle (FTA) was measured on CT and the femoral tunnel length (FTL) was measured intraoperatively. Unpaired t-tests were used to examine differences regarding FTA and FTL between the two groups. The level of significance was set at α=0.05. Results Mean group values (range, standard deviation) for FTA were 33.9º (30º - 41º, 2.9º) and 48.2º (43º - 59º, 4.4 º) and for FTL 36.2mm (30-39, 2.4) and 44.2mm (39-48, 3) for groups A and B respectively (p<0.005). Conclusion With the use of an accessory medial portal the femoral tunnel is placed in a more oblique position in coronal plane as compared to the conventional AM portal technique, closer to the real anatomical position of the posterolateral bundle. Additionally the femoral tunnel length with this new technique is shorter than this with the AM portal but long enough for using the smaller button which has been proposed to reduce the motion of the graft within the tunnel.

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