NDLI: Nonanatomic tunnel position in traditional transtibial single-bundle anterior cruciate ligament reconstruction evaluated by three-dimensional computed tomography.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kopf, Sebastian Forsythe, Brian Wong, Andrew K. Tashman, Scott Anderst, William Irrgang, James J. Fu, Freddie H.
Description	Country affiliation: United States Author Affiliation: Kopf S ( Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.)
Abstract	BACKGROUND: Transtibial drilling techniques are widely used for arthroscopic reconstruction of the anterior cruciate ligament, most likely because they simplify femoral tunnel placement and reduce surgical time. Recently, however, there has been concern that this technique results in nonanatomically positioned bone tunnels, which may cause abnormal knee function. The purpose of this study was to use three-dimensional computed tomography models to visualize and quantify the positions of femoral and tibial tunnels in patients who underwent traditional transtibial single-bundle reconstruction of the anterior cruciate ligament and to compare these positions with reference data on anatomical tunnel positions. METHODS: Computed tomography scans were performed on thirty-two knees that had undergone transtibial single-bundle reconstruction of the anterior cruciate ligament. Three-dimensional computed tomography models were aligned into an anatomical coordinate system. Tibial tunnel aperture centers were measured in the anterior-to-posterior and medial-to-lateral directions on the tibial plateau. Femoral tunnel aperture centers were measured in anatomic posterior-to-anterior and proximal-to-distal directions and with the quadrant method. These measurements were compared with reference data on anatomical tunnel positions. RESULTS: Tibial tunnels were located at a mean (and standard deviation) of 48.0% +/- 5.5% of the anterior-to-posterior plateau depth and a mean of 47.8% +/- 2.4% of the medial-to-lateral plateau width. Femoral tunnels were measured at a mean of 54.3% +/- 8.3% in the anatomic posterior-to-anterior direction and at a mean of 41.1% +/- 10.3% in the proximal-to-distal direction. With the quadrant method, femoral tunnels were measured at a mean of 37.2% +/- 5.5% from the proximal condylar surface (parallel to the Blumensaat line) and at a mean of 11.3% +/- 6.6% from the notch roof (perpendicular to the Blumensaat line). Tibial tunnels were positioned medial to the anatomic posterolateral position (p < 0.001). Femoral tunnels were positioned anterior to both anteromedial and posterolateral anatomic tunnel locations (p < 0.001 for both). CONCLUSIONS AND CLINICAL RELEVANCE: Transtibial anterior cruciate ligament reconstruction failed to accurately place femoral and tibial tunnels within the native anterior cruciate ligament insertion site. If anatomical graft placement is desired, transtibial techniques should be performed only after careful identification of the native insertions. If anatomical positioning of the femoral tunnel cannot be achieved, then an alternative approach may be indicated.
File Format	HTM / HTML
ISSN	00219355
e-ISSN	15351386
DOI	10.2106/JBJS.I.00655
Journal	The Journal of Bone and Joint Surgery-American Volume
Issue Number	6
Volume Number	92
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-06-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopedic surgery Anterior Cruciate Ligament Femur Tibia Adolescent Surgery Arthroscopy Imaging, Three-dimensional Tomography, X-ray Computed Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Nonanatomic Tunnel Position in Traditional Transtibial Single-Bundle Anterior Cruciate Ligament Reconstruction Evaluated by Three-Dimensional Computed Tomography

Comparison of tunnel orientation between transtibial and anteromedial portal techniques for anatomic double-bundle anterior cruciate ligament reconstruction using 3-dimensional computed tomography.

Validation of a new technique to determine midbundle femoral tunnel position in anterior cruciate ligament reconstruction using 3-dimensional computed tomography analysis.

Correlation between femoral tunnel length and tunnel position in ACL reconstruction.

Anterior cruciate ligament reconstruction femoral tunnel characteristics using an accessory medial portal versus traditional transtibial drilling.

Asymmetry in Femoral Tunnel Socket Length During Anterior Cruciate Ligament Reconstruction With Transportal, Outside-In, and Modified Transtibial Techniques.

Tibial tunnel placement accuracy during anterior cruciate ligament reconstruction: independent femoral versus transtibial femoral tunnel drilling techniques.

Transtibial ACL femoral tunnel preparation increases odds of repeat ipsilateral knee surgery.

Anterior cruciate ligament tunnel position measurement reliability on 3-dimensional reconstructed computed tomography.

Nonanatomic tunnel position in traditional transtibial single-bundle anterior cruciate ligament reconstruction evaluated by three-dimensional computed tomography.

Similar Documents

Nonanatomic Tunnel Position in Traditional Transtibial Single-Bundle Anterior Cruciate Ligament Reconstruction Evaluated by Three-Dimensional Computed Tomography

Comparison of tunnel orientation between transtibial and anteromedial portal techniques for anatomic double-bundle anterior cruciate ligament reconstruction using 3-dimensional computed tomography.

Validation of a new technique to determine midbundle femoral tunnel position in anterior cruciate ligament reconstruction using 3-dimensional computed tomography analysis.

Correlation between femoral tunnel length and tunnel position in ACL reconstruction.

Anterior cruciate ligament reconstruction femoral tunnel characteristics using an accessory medial portal versus traditional transtibial drilling.

Asymmetry in Femoral Tunnel Socket Length During Anterior Cruciate Ligament Reconstruction With Transportal, Outside-In, and Modified Transtibial Techniques.

Tibial tunnel placement accuracy during anterior cruciate ligament reconstruction: independent femoral versus transtibial femoral tunnel drilling techniques.

Transtibial ACL femoral tunnel preparation increases odds of repeat ipsilateral knee surgery.

Anterior cruciate ligament tunnel position measurement reliability on 3-dimensional reconstructed computed tomography.

Nonanatomic tunnel position in traditional transtibial single-bundle anterior cruciate ligament reconstruction evaluated by three-dimensional computed tomography.