2017 ISAKOS Biennial Congress IFOSMA ePoster #5035

 

Evaluation of Femoral Tunnel Position Using 3-Dimensional Computed Tomography after Single Bundle Anterior Cruciate Ligament Reconstruction

Suizhu Huang, PhD, Zhengzhou, Henan CHINA
Jiajun Zhao, MD, Zhengzhou, Henan CHINA

Zhengzhou Yihe Hospital Affiliated to Henan University, zhengzhou, henan, china

FDA Status Not Applicable

Summary

Evaluation of Femoral Tunnel Position Using 3-Dimensional Computed Tomography after Single Bundle Anterior Cruciate Ligament Reconstruction

Abstract

Background

The purpose of this study is to investigate the accurate femoral tunnel position with 3-dimensional computed tomography(3D-CT) in patients after single bundle anatomical anterior cruciate ligament(ACL) reconstruction.

Methods

From July 2014 to August 2015, we evaluated 46 patients who underwent primary single bundle anatomical ACL reconstruction, the femoral tunnel position was approached through an additional anterior-medial portal with the knee highly flexed during operation. Their femoral tunnel positions were evaluated with 3D-CT, the ratio of the distance from the center of the femoral tunnel aperture to the proximal condyle surface and to the notch roof was measured using the quadrant method.

Results

According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 27.68%±3.86% from the proximal condyle surface (parallel to the Blumensaat line) and 33.80%±7.01% from the notch roof.

Discussion

The most frequent surgical error causing ACL reconstruction failure is femoral tunnel malposition, in patients with fresh ACL raputure, it is simple to find the center of the footprint, but in most chronic injury and some acute cases, there were no preserved fibers at all, it is difficult to locate the anatomical point of the femoral tunnel in this situation. The bony landmarks: the lateral intercondylar ridge and the bifurcate ridge are useful in this situation. So where is the ideal femoral tunnel position in single bundle anatomical reconstruction?

Conclusion

We can reach a more anatomical approach of the femoral tunnel position in single bundle ACL reconstruction through an additional anterior-medial portal than traditional transtibial technique.