2015 ISAKOS Biennial Congress ePoster #1122

Is it Safe to Reconstruct the Anterolateral Knee Ligament with a Femoral Tunnel? Frequency of LCL and PT Injury

Camilo P. Helito, MD, PhD, Prof, São Paulo, SP BRAZIL
Marco K. Demange, MD, PhD, São Paulo, SP BRAZIL
Marcelo B. Bonadio, MD, São Paulo, SP BRAZIL
Roberto Freire da Mota e Albuquerque, MD, PhD, São Paulo, SP BRAZIL
Riccardo Gomes Gobbi, MD, PhD, São Paulo, SP BRAZIL
Luís Eduardo P. Tírico, MD, São Paulo, SP BRAZIL
José R. Pécora, Prof., São Paulo, SP BRAZIL
Fabio J. Angelini, MD, Sao Paulo, SP BRAZIL
Gilberto L. Camanho, MD, São Paulo, SP BRAZIL
Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil, São Paulo, São Paulo, BRAZIL

FDA Status Not Applicable

Summary: Making a tunnel in the center of the ALL may cause a high rate of iatrogenic injury to the LCL origin. However, no cases of PMT injury are expected to occur with drills smaller than 10 mm.

Rate:

Abstract:

Purpose

This study sought to establish the distance between the anterolateral ligament (ALL) and the lateral collateral ligament (LCL) and between the ALL and of the popliteus muscle tendon (PT) to determine the safety limit for making a bone tunnel to reconstruct the ALL.

Methods

In total, 48 cadaveric knees were used. The origin of the ALL and LCL and the PT insertion were isolated, and the distance between the structures was measured. For each cadaver, the percentage of cases in which at least 50% of the LCL and PT would be injured when using 4- to 12-mm-diameter drills in an ALL reconstruction procedure was evaluated.

Results

The mean distance between the ALL and LCL was 3.8 mm and between the ALL and PT was 10.2 mm. A 4-mm tunnel would cause LCL injury in 8.3% of cases, with increasing incidence of injury up to 87.5% with a 12-mm drill. Injury to the PT would start with the 10-mm drill, causing injury in 2.0% of cases.

Conclusions

Making a tunnel in the center of the ALL may cause a high rate of iatrogenic injury to the LCL origin. However, no cases of PT injury are expected to occur with drills smaller than 10 mm.