ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #800

 

Tibial Tunnel Evaluation in ACL Reconstruction with and without Remnant Preservation: Are We in the Correct Place?

Vitor B. Padua, MD, Marilia, SP BRAZIL
Universidade de Marilia, Marilia, SP, BRAZIL

FDA Status Not Applicable

Summary

In the ACL reconstruction is possible to achieve the correct placement of the tibia tunnel with and without remnant preservation as demonstrated by 3-D computed tomography.

Abstract

Introduction

The remnant preservation in the anterior cruciate ligament (ACL) reconstruction has the advantage of maintaining the original biology such as vascularization and proprioception. However, the volume of the remnant can disrupt the foot print identification and compromise the correct placement of the bone tunnels, mainly in the tibia.

Purpose

The purpose of this study was to compare the tibial tunnel positioning in anterior cruciate ligament (ACL) reconstruction with an anteromedial (AM) single bundle, with and without remnant preservation through computed tomography with three-dimensional reconstruction.

Methods

Two groups of 9 patients were submitted to ACL reconstruction with the hamstring, with independent tunnels perforation (OUT-IN). Group 1 without the presence of ACL remnant, where it was possible to visualize all tibial foot print, and group 2 where the ACL remnant covered all the foot print and the graft was passed through the remnant.
3-D computed tomography was performed between 30 and 60 days postoperatively and the location of the tibial tunnel was measured on anteroposterior and mediolateral diameter.

Results

The mean location of the center of the tibial tunnel was 34,13% (SD, 2,1%) without remnant and 36,92% (SD, 3,5%) with remnant preservation in the anteroposterior diameter. Regarding the mediolateral positioning, the tunnel center was placed at 47,42% (SD, 2,4%) without and 47,27% (SD, 2,8%) with remnant preservation. Comparing both groups measurements, the difference was not statistically significant and the tunnel position accords with anatomic studies of AM bundle tibial insertion.

Conclusion

In the ACL reconstruction is possible to achieve the correct placement of the tibia tunnel with and without remnant preservation as demonstrated by 3-D computed tomography.