scholarly journals Comparison of functional outcome of ACL reconstruction using modified transtibial technique (MTT) and transportal technique (TP) for making the femoral tunnel in a randomised prospective study

2018 ◽  
Vol 4 (3.6) ◽  
pp. 595-597
Author(s):  
KP Saravanakumar ◽  
S Madhu
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Transtibial Technique ◽  
Transportal Technique

scholarly journals Modified Transtibial versus Anteromedial Portal Technique in Single Bundle ACL Reconstruction

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0002
Author(s):  
Emiliano Alvarez Salinas ◽  
Horacio Rivarola Etcheto ◽  
Cristian Collazo Blanchod ◽  
Gonzalo Escobar ◽  
Jesuan Zordan ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Sagittal Plane ◽  
Femoral Tunnel ◽  
Average Distance ◽  
Average Diameter ◽  
Single Bundle ◽  
Transtibial Technique ◽  
Group I ◽  
Group Ii ◽  
Transportal Technique

Objectives: The aim of this study is to determine whether it is possible to achieves a similar anatomical placement of the femoral tunnel with a modified transtibial ACL single bundle reconstruction tecnique compared to anteromedial transportal technique. Results were evaluated by tomographic comparisons between patients from both groups. Methods: 36 patients (36 knees) who were candidates for an ACL single bundle reconstruction with patellar bone graft were included in the study. Patients were randomly allocated using a computerized sequence into two groups. 18 patients were assigned each group (modified transtibial vs AM transportal technique). Surgery was performed by the same surgical team in both groups. Femoral tunnel quadrant placement, oblicuity in the coronal and sagittal planes and diameter of the femoral tunnel were assesed tomographically blinded by two observers and statistical comparison between groups was realized. Results: Average distance measured from posterior edge of the condyle to the femoral tunnel ( measured as a proportion respect to the T line) was similar in both groups ( Group I : 32.7 % +- 5.1% ; Group 2: 32.4 % +-4.4% , p = 0.85). Average distance measured from the Blumensaat line to the femoral tunnel (measured as a proportion respect to the H line) was similar in both groups ( Group I: 28.5% 4.49 % Group II , 31.5% of 4.83% p = 0.06). Average angulation values of the femoral tunnel in the coronal plane were lower in Group I than in Group II (Group I = 34.8 ° range 32.7 ° - 38.6 ° and 41.2 ° range Group II 36.7 ° - 43.1 ° P = 0.0016 ). Average angulation values of the femoral tunnel in the sagittal plane were similar in both groups (Group I 40.2 ° range 38.4 ° - 43.4 ° ; Group II 38 1 ° range 36.6 ° - 40.2 ° p = 0.17).. The average diameter of the femoral tunnel was significantly higher in group I than in Group II (Group I 11 mm 0.84 mm and 10.2 mm Group II 0.65mm p = 0.007) . Conclusion: The modified transtibial technique for single bundle ACL reconstruction has proved to be suitable to reproduce the anatomic placement of the femoral tunnel compared to the transportal AM technique.

Three dimensionalCT analysis of femoral tunnel position after ACL reconstruction. A prospective study of one hundred and thirty five cases

2017 ◽  
Vol 41 (11) ◽  
pp. 2313-2319 ◽  
Author(s):  
Olivier Reynaud ◽  
Cécile Batailler ◽  
Timothy Lording ◽  
Sebastien Lustig ◽  
Elvire Servien ◽  
...  
Keyword(s):  
Prospective Study ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Tunnel Position ◽  
Femoral Tunnel Position ◽  
A Prospective Study

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

2020 ◽  
Author(s):  
Takanori Iriuchishima ◽  
Bunsei Goto
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Target Point ◽  
Single Bundle ◽  
Anterior Cruciate ◽  
Transportal Technique

AbstractThe purpose of this systematic review was to reveal the trend in surgical technique and tunnel targets points and placement in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, data collection was performed. PubMed, EMBASE, and Cochran Review were searched using the terms “anterior cruciate ligament reconstruction,” “anatomic or anatomical,” and “single bundle.” Studies were included when they reported clinical results, surgical technique, and/or tunnel placement evaluation. Laboratory studies, technical reports, case reports, and reviews were excluded from this study. From these full article reviews, graft selection, method of creating the femoral tunnel, and femoral and tibial tunnel target points and placement were evaluated. In the 79 studies included for data evaluation, the selected grafts were: bone patella tendon bone autograft (12%), and hamstring autograft (83%). The reported methods of creating the femoral tunnel were: transportal technique (54%), outside-in technique (15%), and transtibial technique (19%). In the 60 studies reporting tunnel target points, the target point was the center of the femoral footprint (60%), and the center of the anteromedial bundle footprint (22%). In the 23 studies evaluating tunnel placement, the femoral tunnel was placed in a shallow–deep direction (32.3%) and in a high–low direction (30.2%), and the tibial tunnel was placed from the anterior margin of the tibia (38.1%). The results of this systematic review revealed a trend in anatomical single-bundle ACL reconstruction favoring a hamstring tendon with a transportal technique, and a tunnel target point mainly at the center of the ACL footprint. The level of evidence stated is Systematic review of level-III studies.

scholarly journals Optimal Condition to Create Femoral Tunnel Considering Combined Influence of Knee Flexion and Transverse Drill Angle in Anatomical Single-Bundle ACL Reconstruction Using Medial Portal Technique: 3D Simulation Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Sung-Hwan Kim ◽  
Sung-Jae Kim ◽  
Chong Hyuk Choi ◽  
Dohyun Kim ◽  
Min Jung
Keyword(s):  
Optimal Condition ◽  
Acl Reconstruction ◽  
Knee Flexion ◽  
Femoral Tunnel ◽  
Flexion Angle ◽  
Single Bundle ◽  
Tunnel Length ◽  
Bending Angle ◽  
Graft Bending Angle ◽  
Transportal Technique

There has been no previous study using three-dimensional (3D) measurement on femoral tunnel characteristics according to the combined influence of various flexion angles of knee and transverse drill angles in single-bundle ACL reconstruction with transportal technique. The purpose of this study was to determine optimal condition of knee flexion angle and transverse drill angle to create secure femoral tunnel in single-bundle ACL reconstruction with transportal technique considering tunnel length, tunnel wall breakage, and graft bending angle. This study was conducted using simulation of 3D computed tomography of thirty subjects. Three variables of femoral tunnel changed according to combined influence of four flexion angles of knee and three transverse drill angles were measured: tunnel length, wall breakage, and graft bending angle. There was no case of short femoral tunnel less than 25 mm at 120° and 130° of flexion. There was no case of breakage of femoral tunnel at 120° of flexion with maximum transverse drill angle (MTA) and MTA-10° and at 130° of flexion. Considering effect on graft bending angle, decrease of flexion angle and transverse drill angle could be appropriate in creating femoral tunnel. Increased flexion angle and transverse drill angle secured femoral tunnel having sufficiently long length without wall breakage. However, avoiding excessive flexion angle and maximum transverse drill angle could be recommended because they tended to cause more acute graft bending angle.

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