scholarly journals The tibial aperture surface analysis in anterior cruciate ligament reconstruction process

2016 ◽  
Vol 69 (3-4) ◽  
pp. 99-105
Author(s):  
Zoran Milojevic ◽  
Slobodan Tabakovic ◽  
Marija Vicevic ◽  
Mirko Obradovic ◽  
Miodrag Vranjes ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Surface Area ◽  
Ligament Reconstruction ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Cruciate Ligament Reconstruction ◽  
Tibial Bone ◽  
Anterior Cruciate

Introduction. The tibial tunnel aperture in the anterior cruciate ligament reconstruction is usually analyzed as an ellipse, generated as an intersection between a tibial plateau and a tibial bone tunnel. The aim of this study is to show that the tibial tunnel aperture, which utilizes 3D tibial surface bone model, differs significantly from common computations which present the tibial tunnel anterior cruciate ligament aperture surface as an ellipse. Material and Methods. An interactive program system was developed for the tibial tunnel aperture analysis which included the real tibia 3D surface bone model generated from a series of computed tomography images of ten male patients, their mean age being 25 years. In aperture calculation, the transverse drill angle of 10o was used, whereas sagittal drill angles of 40o, 50o and 60o were used with the drill-bit diameter set to 10 mm. The real 3D and 2D tibial tunnel aperture surface projection was calculated and compared with an ellipse. Results. According to the calculations, generated 3D aperture surfaces were different for every patient even though the same drill parameters were used. For the sagittal drill angles of 40?, 50? and 60?, the mean difference between the projected 3D and 2D area on the tibial plateau was 19.6 ? 5.4%, 21.1 ? 8.0% and 21.3 ? 9.6%, respectively. The difference between the projected 3D area on the tibial plateau and ellipse surface was 54.8 ? 16.3%, 39.6 ? 10.4% and 25.0 ? 8.0% for sagittal drill angles of 40?, 50? and 60?, respectively. Conclusion. The tibial tunnel aperture surface area differs significantly from the ellipse surface area, which is commonly used in the anterior cruciate ligament reconstruction analysis. Inclusion of the 3D shape of the tibial attachment site in the preoperative anterior cruciate ligament reconstruction planning process can lead to a more precise individual anatomic anterior cruciate ligament reconstruction on the tibial bone. Both tibial aperture area generated in 3D and its projection on a tibial plateau are larger than the ellipse surface; therefore, individual characteristics of each patient have to be taken into consideration.

scholarly journals Extra-articular migration of PEEK interference screw after anterior cruciate ligament reconstruction: a report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Hua Fang ◽  
Ming Li ◽  
Yun-Feng Zhang ◽  
Hua Liu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Interference Screw ◽  
Negative Effects ◽  
Cruciate Ligament Reconstruction ◽  
Screw Extrusion ◽  
Anterior Cruciate

Abstract Background The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, “bioresorbable,” or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. Case report An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. Conclusions The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.

Comparison of Three Techniques of Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Graft: Differences in Anterior Tibial Translation and Tunnel Enlargement with Each Technique

2003 ◽  
Vol 31 (2) ◽  
pp. 282-288 ◽  
Author(s):  
Hironori Otsuka ◽  
Yasuyuki Ishibashi ◽  
Eiichi Tsuda ◽  
Kazuhiro Sasaki ◽  
Satoshi Toh
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Enlargement ◽  
Cruciate Ligament Reconstruction ◽  
Fixation Group ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

Background: Anatomic fixation of the graft in anterior cruciate ligament reconstruction has improved stability of the reconstructed knee joint in experimental studies. Hypothesis: Anatomic fixation of the bone-patellar tendon-bone autograft will reduce tunnel enlargement and improve clinical results. Study Design: Prospective cohort study. Methods: Sixty patients were randomly divided into three groups: a nonanatomic fixation group (traditional single-incision reconstruction), an anatomic fixation group (reconstruction in which a bone plug was grafted into the tibial tunnel), and an anatomic fixation group with all-inside reconstruction. Stability of the knee joint was examined with a KT-1000 arthrometer at 2, 4, 6, 12, and 24 months after surgery. At 12 months, anteroposterior and lateral radiographs were made to assess tunnel enlargement. Results: Although the magnitude of tibial displacement gradually increased after reconstruction in all three groups, the anatomic fixation group had significantly better stability than the groups undergoing nonanatomic fixation or all-inside anatomic fixation at 4 and 6 months after anterior cruciate ligament reconstruction. However, there was no significant difference between the three groups at 24 months. Regarding the tibial tunnel, residual rates and enlargement of tunnels were different between the reconstruction techniques. The nonanatomic reconstruction group had significantly greater tunnel enlargement. Conclusion: Anatomic fixation of the graft decreased the tunnel enlargement but had no effect on knee stability at 2-year follow-up.

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