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Ideal Combination Of Anatomic Tibial And Femoral Tunnel Positions for Single-Bundle ACL Reconstruction

Ideal Combination Of Anatomic Tibial And Femoral Tunnel Positions for Single-Bundle ACL Reconstruction

Kyoung-Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF

Department of Orthopaedic Surgery, Kyung Hee University Hospital , Seoul, Seoul, KOREA, REPUBLIC OF


2023 Congress   ePoster Presentation   2023 Congress   rating (1)

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

ACL

Patient Populations

Diagnosis Method


Summary: No significant differences in clinical scores, knee joint stability, or graft signal intensity on follow-up MRI were identified between the patients with anteromedially and posterolaterally positioned tunnels.


Background

Anatomic anterior cruciate ligament reconstruction (ACLR) is preferred over nonanatomic ACLR. However, there is no consensus on which point the tunnels should be positioned among the broad anatomic footprints.

Purpose/Hypothesis:
To identify the ideal combination of tibial and femoral tunnel positions according to the femoral and tibial footprints of the anteromedial (AM) and posterolateral (PL) anterior cruciate ligament bundles. It was hypothesized that patients with anteromedially positioned tunnels would have better clinical scores, knee joint stability, and graft signal intensity on follow-up magnetic resonance imaging (MRI) than those with posterolaterally positioned tunnels.

Study Design:
Cohort study; Level of evidence, 3.

Methods

A total of 119 patients who underwent isolated single-bundle ACLR with a hamstring autograft from July 2013 to September 2018 were retrospectively investigated. Included were patients with clinical scores and knee joint stability test results at 2-year follow-up and postoperative 3-dimensional computed tomography and 1-year postoperative MRI findings. The cohort was divided into 4 groups, named according to the bundle positions in the tibial and femoral tunnels: AM-AM (n = 33), AM-PL (n = 26), PL-AM (n = 29), and PL-PL (n = 31).

Results

There were no statistically significant differences among the 4 groups in preoperative demographic data or postoperative clinical scores (Lysholm, Tegner, and International Knee Documentation Committee subjective scores); knee joint stability (anterior drawer, Lachman, and pivot-shift tests and Telos stress radiographic measurement of the side-to-side difference in anterior tibial translation); graft signal intensity on follow-up MRI; or graft failure.

Conclusion

No significant differences in clinical scores, knee joint stability, or graft signal intensity on follow-up MRI were identified between the patients with anteromedially and posterolaterally positioned tunnels.


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