2015 ISAKOS Biennial Congress ePoster #1246
Creation of Anatomic Tibial Tunnels Using Posterior Cruciate Ligament Fovea Landmarks During Trans-Tibial Posterior Cruciate Ligament Reconstruction
Yong-Seuk Lee, MD, PhD, Prof., Seongnam, Kyung-gi KOREA, REPUBLIC OF
Jin-Hwan Ahn, MD, Seoul KOREA, REPUBLIC OF
Myung Chul Lee, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Won Seok Oh, MD, Incheon KOREA, REPUBLIC OF
Seoul national university bundang hospital and Kangbuk samsung hospital, seongnam and seoul, Kyung-gi and Seoul, KOREA
FDA Status Not Applicable
Summary: PCL fovea landmark technique may be used as a method comparable to the C-arm technique for locating the anatomic tibial tunnel.
Anatomically, posterior cruciate ligament (PCL) fovea is distinct from the vertical cortex of the tibia and appears as a consistent radiographic landmark for pin placement in PCL reconstruction.
The hypothesis of this study was that appropriate anatomic tunnel locations would be produced using this landmark, without C-arm assistance, and that this technique could be an alternative method for determining the anatomic location of the tibial tunnel.
Study design: Case-Control study
This retrospective comparison focused on the tibial tunnel locations determined in 26 patients using C-arm technique (group I) and in 23 patients using the PCL fovea landmark technique (group II) between 2011 and 2014. The 3D CT images that appropriately located the position of PCL fovea on the tibial plateau and sagittal images were evaluated. Seven different parameters were measured, including the total sagittal length, sagittal tunnel length, ratio between the sagittal tunnel length and the total sagittal length, total coronal length, coronal tunnel length, ratio between the coronal tunnel length and the total coronal length, and the length of the posterior bone bridge.
The total sagittal lengths in group I and II were 19.2 ± 2 mm and 17.7 ± 5 mm, respectively (p=0.55). The sagittal tunnel lengths in groups I and II were 6.8 ± 2.5 mm and 7.4 ± 3.7 mm, respectively (p=0.21). Therefore, the ratios between sagittal tunnel length and total sagittal length for groups I and II were 35.4 ± 12.2 % and 44.1 ± 23.1 %, respectively (p=0.07). Similarly, the total coronal lengths in groups I and II were 15.7 ± 1.5 mm and 14.9 ± 1.5 mm, respectively (p=0.08). The coronal tunnel lengths in groups I and II were 7.4 ± 1.5 mm and 8.4 ± 2.6 mm, respectively (p=0.07). Thus, the ratios between the coronal tunnel lengths and total coronal lengths for groups I and II were 47.3 ± 9.2 % and 57.3 ± 18.1 %, respectively: group II showed more laterally positioned tibial tunnel than did group I (p=0.03). There were cortical breakages in 2 group I and in 3 group II patients.
The PCL fovea landmark technique may be used as
comparable to the C-arm technique for locating the anatomic tibial tunnel during trans-tibial PCL reconstruction.