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Can we use intraoperative femoral tunnel length measurement as a clue for proper femoral tunnel placement on coronal plane during ACL reconstruction?

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Successful anterior cruciate ligament (ACL) reconstruction is dependent on correct placement of both tibial and femoral tunnels. The purpose of this study is to investigate whether we can use intraoperative femoral tunnel length measurement to estimate the correct femoral tunnel placement on coronal plane.

Methods

This prospective study comprised 164 consecutive patients who underwent ACL reconstruction surgery. Transtibial or anteromedial portal technique is used for drilling the femoral tunnels. The length of the femoral tunnel was measured during the operation. The femoral tunnel coronal plane angle was calculated on the postoperative tunnel radiographs. A statistical comparison was made of the lengths of the tunnel, the techniques used drilling and the femoral tunnel angles.

Results

The far anteromedial portal was used in 81 (49 %) cases and the transtibial technique in 83 (51 %) cases. The mean femoral tunnel length was 42 ± 6.4 mm and the mean femoral tunnel coronal angle was 41.1° ± 11.6. The tunnel angle in the transtibial technique was determined as significantly low compared to the far anteromedial portal technique (32.6°:49.8°) and the tunnel length was significantly longer (45.8:38.1 mm) (p < 0.001). In the statistical analysis, it was found that a patient with a tunnel length of 41 mm and above had a 92.1 % likelihood of femoral tunnel angle below 45°.

Conclusion

Femoral tunnel length can be used as a clue for intraoperative evaluation of the femoral tunnel position. If the femoral tunnel length is greater than 41 mm, the coronal plane orientation of the femoral tunnel will be improper and not at a desired position.

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Conflict of interest

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Private Ortopedia Hospital, Adana, Turkey

    Mustafa Celiktas, Yaman Sarpel & Mahir Gulsen

  2. Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey

    Ozkan Kose

  3. Kultur mah. 3805. sk. Durukent sitesi, F Blok Daire:22 Kepez, Antalya, Turkey

    Ozkan Kose

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  1. Mustafa Celiktas
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  2. Ozkan Kose
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  3. Yaman Sarpel
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  4. Mahir Gulsen
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Correspondence to Ozkan Kose.

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Celiktas, M., Kose, O., Sarpel, Y. et al. Can we use intraoperative femoral tunnel length measurement as a clue for proper femoral tunnel placement on coronal plane during ACL reconstruction?. Arch Orthop Trauma Surg 135, 523–528 (2015). https://doi.org/10.1007/s00402-015-2173-2

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  • DOI: https://doi.org/10.1007/s00402-015-2173-2

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