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Comparable clinical and radiological outcomes between anatomical and high femoral tunnels in posterior cruciate ligament reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare clinical and radiological outcomes and failure rates between anatomical and high femoral tunnels in remnant-preserving single-bundle posterior cruciate ligament (PCL) reconstruction.

Methods

63 patients who underwent remnant-preserving single-bundle PCL reconstruction between 2011 and 2018 with a minimum 2-year follow-up were retrospectively reviewed. Patients were divided into two groups according to the femoral tunnel position: group A (33 patients with anatomical femoral tunnel) and group H (30 patients with high femoral tunnels). The femoral tunnel was positioned at the center (group A) or upper margin (group H) of the remnant anterolateral bundle. The position of the femoral tunnel was evaluated using the grid method on three-dimensional computed tomography. Clinical and radiological outcomes and failure rates were compared between the groups at the 2-year follow-up.

Results

The position of the femoral tunnel was significantly high in group H than in group A (87.4% ± 4.2% versus 76.1% ± 3.7%, p < 0.001). Clinical outcomes were not significantly different between the two groups in terms of the clinical scores (International Knee Documentation Committee subjective, Lysholm, and Tegner activity scores), range of motion, and posterior drawer test. Radiological outcomes also showed no intergroup differences in the side-to-side differences of posterior tibial translation and osteoarthritis progression. Side-to-side difference on the Telos stress radiograph was 5.2 ± 2.9 mm in group A and 5.2 ± 2.7 mm in group H (n.s.). There were four failures in group A (12.1%) and one in group H (3.3%). The differences between the groups were not statistically significant.

Conclusion

The clinical and radiological outcomes and failure rates of the high femoral tunnels were comparable with those of the anatomical femoral tunnels at the 2-year follow-up after remnant-preserving single-bundle PCL reconstruction. The findings of this study suggest that high femoral tunnels can be considered an alternative in remnant-preserving single-bundle PCL reconstruction.

Level of evidence

III.

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

This study received no funding.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea

    Kyoung Ho Yoon, Jung-Suk Kim & Jae-Young Park

  2. Department of Physical Education, Graduate School of Education, Yongin University, Yongin-si, Gyeongki-do, Republic of Korea

    Soo Yeon Park

  3. Department of Orthopaedics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia

    Raymond Yeak Dieu Kiat

  4. Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeongki-do, Republic of Korea

    Sang-Gyun Kim

Authors
  1. Kyoung Ho Yoon
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  2. Jung-Suk Kim
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  3. Jae-Young Park
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  4. Soo Yeon Park
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Corresponding author

Correspondence to Sang-Gyun Kim.

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The authors declare that they have no conflict of interest related to this study.

Ethical approval

This study was approved by the institutional review board. (ID: 2020–02-020, Kyung Hee University Hospital).

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Acquisition of informed consent was not applicable in this study.

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Yoon, K.H., Kim, JS., Park, JY. et al. Comparable clinical and radiological outcomes between anatomical and high femoral tunnels in posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 29, 1936–1943 (2021). https://doi.org/10.1007/s00167-020-06266-0

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  • DOI: https://doi.org/10.1007/s00167-020-06266-0

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