Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction by Low Accessory Anteromedial Portal Technique: An In Vivo 3D CT Study
- Author:
Kwang Won LEE
1
;
Yoon Sub HWANG
;
Yong Joo CHI
;
Dae Suk YANG
;
Ha Yong KIM
;
Won Sik CHOY
Author Information
1. Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea. poxkoreana@gmail.com
- Publication Type:Original Article
- Keywords:
Knee;
Anterior cruciate ligament reconstruction;
Arthroscopy;
Anteromedial portal;
Computed tomography
- MeSH:
Anterior Cruciate Ligament;
Anterior Cruciate Ligament Reconstruction;
Arthroscopy;
Humans;
Knee;
Transplants
- From:The Journal of Korean Knee Society
2014;26(2):97-105
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Proper femoral tunnel position is important for anatomical reconstruction of the anterior cruciate ligament (ACL). The purpose of this study was to evaluate the positions of femoral and tibial tunnels created using an accessory anteromedial portal technique in single bundle ACL reconstruction. MATERIALS AND METHODS: The femoral tunnel was targeted at the mid-portion of the ACL bundles. We evaluated postoperative computed tomography scans of 32 patients treated by ACL reconstruction using a free-hand low accessory anteromedial portal technique. On the tibial side, the tunnel position was evaluated using Tsukada's method. On the femoral side, the position was evaluated using 1) the quadrant method, 2) Mochizuki's method, 3) Mochizuki's method, and 4) Takahashi's method. Tunnel obliquity was also evaluated. RESULTS: The mean tibial tunnel position was located at 44.6%+/-2.5% anterior from the anterior margin and 48.0%+/-3.0% in medial from the medial margin. The mean femoral tunnel position was located at the center between the anteromedial and posterolateral bundles: Quadrant method, 26.7%+/-2.7%/30.0%+/-2.9%; Watanabe's method, 37.7%+/-2.5%/26.6%+/-2.2%; Mochizuki's method, 38.7%+/-2.7%; Takahashi's method, 21.8%+/-2.2%. The mean femoral tunnel obliquity was 57.7degrees+/-6.2degrees in the sagittal plane and 49.9degrees+/-5.6degrees in the coronal plane. CONCLUSIONS: In anatomic single bundle ACL reconstruction, the low anteromedial portal technique can restore accurate position of the native footprint. Accurate femoral tunnel position facilitates recovery of stability and decreases graft failure rate.
