2015 ISAKOS Biennial Congress ePoster #1267

Comparison of Clinical Outcomes in the Two Different Femoral Tunnel Locations in Anatomic Single-Bundle Anterior Cruciate Ligament (ACL) Reconstruction

Yoshitomo Saita, MD, PhD, Tokyo JAPAN
Yuji Takazawa, MD, PhD, Tokyo JAPAN
Hiroshi Ikeda, MD, PhD, Tokyo JAPAN
Muneaki Ishijima, MD, PhD, Tokyo JAPAN
Haruka Kaneko, Tokyo JAPAN
Kazuo Kaneko, MD, PhD, Prof., Tokyo JAPAN

Department of Orthopaedics, Juntendo University, Tokyo, JAPAN

FDA Status Not Applicable

Summary: Anatomic single-bundle ACL reconstruction with tunnels positioned in the center of the femoral and tibial footprints had good clinical outcomes and less rotatory instability in comparison to the center-AM technique.

Rate:

Abstract:

Objectives:
The purpose of this study was to compare the clinical outcomes after anterior cruciate ligament (ACL) reconstruction using 2 modern clinically relevant femoral tunnel placements.

Methods

The clinical results of ACL reconstruction with semitendinosus tendon (five strands) were retrospectively compared in the 127 patients. A minimum follow-up was two years. The clinical outcomes were compared in two groups divided by the femoral tunnel placement. The tibial tunnel was centered in the anatomic tibial footprint in all patients, while the femoral tunnel was reamed through the anteromedial portal and centered alternately in either the center of femoral footprint of anteromedial bundle in 88 patients (center-AM, group A) or the center of the anatomic ACL footprint in 39 patients (center-center, group B).

Results

The tunnel position was analyzed by the quadrant method in intraoperative radiograph. The center of the femoral tunnel was located at a depth of 27.2 ± 4.7 % (average ± SD) and a height of 21.1 ± 3.3 % in group A, and those in group B was 25.7 ± 4.0 % and 37.1 ± 3.6 % respectively. The average of follow-up period was 31.5 ± 9.4 months in group A and that in group B was 31.0 ± 6.5 months. At follow-up, there was no significant difference in the clinical scores such as IKDC, Lysholm, and Tegner scores. The KT-2000 side-to-side measurement at 30 pounds showed no significant difference between two groups (group A: 1.25 ± 0.92 mm, group B: 0.99 ± 0.86 mm). The ratio of negative pivot shift test was significantly higher in group B (94.9 %) compared to that in group A (76.1 %) (p<0.01). Return to sport participation was 9.0 months in both groups. The re-injury rate tended to low in group B (2.7 %) in comparison to that in group A (5.7 %) but there was no significant difference (p=0.3).

Conclusion

Anatomic single-bundle ACL reconstruction with tunnels positioned in the center of the femoral and tibial footprints had good clinical outcomes and less rotatory instability in comparison to the center-AM technique.