Comparison of femoral tunnel length between transportal and retrograde reaming outside-in techniques in anterior cruciate ligament reconstruction
- 674 Downloads
To evaluate the accuracy of intraoperative femoral tunnel length measurement and to compare this between the transportal (TP) and outside-in (OI) techniques for double-bundle (DB) anterior cruciate ligament (ACL) reconstruction.
Eighty patients underwent a DB ACL reconstruction using either the TP or the OI technique. The participants were randomized to either a TP group (I, 40 cases) or a OI group (II, 40 cases). The intraoperatively measured femoral tunnel length was recorded, and the postoperative femoral tunnel length was measured using computed tomography with OsiriX® imaging software.
The mean femoral tunnel lengths measured intraoperatively in Group II (38.9 ± 3.0 mm for anteromedial [AM], 39.3 ± 3.4 mm for posterolateral [PL]) were significantly longer than those of Group I (34.8 ± 2.7 mm for AM, 36.0 ± 3.2 mm for PL) (P < 0.001). The mean AM femoral tunnel length measured postoperatively in Group II (33.3 ± 3.8 mm) was significantly longer than that in Group I (31.1 ± 2.9 mm) (P = 0.006). The mean intraoperatively measured femoral tunnel length was significantly longer than that measured postoperatively in Groups I and II (P < 0.001).
After anatomic DB ACL reconstruction, the femoral tunnel length of the OI technique measured intraoperatively (AM/PL) and postoperatively (AM) was longer than those of the TP technique. The femoral tunnel length measured intraoperatively was longer than that measured postoperatively in both TP and OI technique. This study may help surgeons to measure femoral tunnel length accurately in anatomic DB ACL reconstruction with suspensory fixation device.
Level of evidence
Prospective randomized controlled trial, Level I.
KeywordsAnterior cruciate ligament Transportal Retrograde reaming Outside-in Femoral tunnel length
This study was supported by a grant of the Korea Health technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A101029).
Conflict of interest
No conflicts of interest present in this study.
- 2.Baumfeld J, Diduch D, Rubino L, Hart J, Miller M, Barr M, Hart J (2008) Tunnel widening following anterior cruciate ligament reconstruction using hamstring autograft: a comparison between double cross-pin and suspensory graft fixation. Knee Surg Sports Traumatol Arthrosc 16:1108–1113PubMedCrossRefGoogle Scholar
- 5.Bowers AL, Bedi A, Lipman JD, Potter HG, Rodeo SA, Pearle AD, Warren RF, Altchek DW (2011) Comparison of anterior cruciate ligament tunnel position and graft obliquity with transtibial and anteromedial portal femoral tunnel reaming techniques using high-resolution magnetic resonance imaging. Arthroscopy 27:1511–1522PubMedCrossRefGoogle Scholar
- 7.Choi NH, Lee JH, Victoroff BN (2007) Do broken cross-pins compromise stability after anterior cruciate ligament reconstructions with hamstring tendons? Arthroscopy 23(1334–1340):e1332Google Scholar
- 26.Weiler A, Peine R, Pashmineh-Azar A, Abel C, Sudkamp NP, Hoffmann RF (2002) Tendon healing in a bone tunnel. Part I: biomechanical results after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep. Arthroscopy 18:113–123PubMedCrossRefGoogle Scholar