Accuracy of Femoral Tunnel Placement between Anteromedial and Anterolateral Visualisation Portals in Anterior Cruciate Ligament Reconstruction - Outcomes of a CT based Cross-Sectional Study
https://doi.org/10.5704/MOJ.2307.002
- Author:
Balaji G
1
;
Yadav G
1
;
Patel SA
1
;
Ramesh A
1
;
Nema S
1
;
Ramalingam T
2
Author Information
1. Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
2. Department of Orthopaedics, Sarvajanik College of Physiotherapy Rampura, Surat, India
- Publication Type:Journal Article
- Keywords:
tunnel placement, anatomic, anterior cruciate, portal
- From:Malaysian Orthopaedic Journal
2023;17(No.2):7-12
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Anatomical femoral tunnel placement is
critical for anterior cruciate ligament reconstruction
(ACLR). Tunnel placement may vary with different surgical
techniques. The aim of this study was to compare the
accuracy of femoral tunnel placement between the
Anteromedial (AM) and Anterolateral (AL) visualisation
portals on post-operative CT scans among a cohort of ACLR
patients.
Materials and methods: This cross-sectional study was
conducted from January 2018 to March 2020 after obtaining
ethics clearance. Patients who went for arthroscopic ACLR
in our institute were divided into an AM (group 1) and an AL
(group 2) based on the visualisation portal for creating the
femoral tunnel and a 3D CT scan was done. The femoral
tunnel position was calculated in deep to shallow and high to
low direction using the Bernard Hertel grid. Femoral tunnel
angle was measured in the 2D coronal image. Statistical
analysis was done with the data collected.
Results: Fifty patients with an average age of 26.36 (18-55)
years ±7.216 SD were enrolled in the study. In this study, the
AM technique was significantly more accurate (p<0.01) than
the AL technique in terms of femoral tunnel angle.
Furthermore, the deep to the shallow position was
significantly (p= 0.018) closer to normative values, as
determined by the chi-square test. The chances of error in
tunnel angle in femoral condyle are 2.6 times greater in the
AL technique (minimal clinical difference).
Conclusion: To conclude, in ACLR the anteromedial
visualisation portal can facilitate accurate femoral tunnel
placement compared to the anterolateral visualisation portal.
- Full text:16.2023my1313.pdf
