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Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate which technique would reduce bending stress at the femoral tunnel aperture and make short tunnel length after ACL reconstruction by comparing the femoral graft bending angle and tunnel length between the single-bundle (SB) transtibial (TT) and double-bundle (DB) transportal (TP) technique using three-dimensional-computed tomography using OsiriX® imaging software.

Methods

Forty-nine patients underwent an ACL reconstruction using a SB TT (Group I, 20 patients) and DB TP (Group II, 29 patients) technique. Femoral graft bending angle and femoral tunnel length were measured by CT image using OsiriX® imaging software. Groups I and II were compared, and statistical analysis was performed using SPSS software.

Results

The mean anteromedial (AM) and posterolateral (PL) femoral graft bending angle of group II (111.5 ± 8.8° and 118.9 ± 9.8°, respectively) was significantly more acute than that of group I (125.3 ± 11.1°) (P < 0.001, P = 0.04). The mean femoral tunnel length of group I was significantly longer than that of group II (P = 0.001).

Conclusions

The femoral graft bending angle and the femoral tunnel length of the TP technique performed in the maximally flexed knee position was more acute and shorter than those of the TT technique after ACL reconstruction. This might increase the bending stress at the femoral tunnel aperture and shorter graft length in the tunnel after an ACL reconstruction using TP technique compared to the TT technique.

Level of evidence

III.

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Conflict of interest

No conflicts of interest present in this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea

    Joon Ho Wang & Do Kyung Lee

  2. Department of Orthopedic Surgery, College of Medicine, Korea University, Guro Hospital, 80 Guro-dong, Guro-gu, Seoul, 152-703, South Korea

    Jae Gyoon Kim & Hong Chul Lim

  3. Department of Orthopedic Surgery, School of Medicine, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, South Korea

    Jin Hwan Ahn

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  1. Joon Ho Wang
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  2. Jae Gyoon Kim
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  3. Do Kyung Lee
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Correspondence to Jae Gyoon Kim.

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Wang, J.H., Kim, J.G., Lee, D.K. et al. Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20, 1584–1593 (2012). https://doi.org/10.1007/s00167-011-1781-9

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  • DOI: https://doi.org/10.1007/s00167-011-1781-9

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