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No differences in clinical outcomes and graft healing between anteromedial and central femoral tunnel placement after single bundle ACL reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to compare clinical outcomes and graft healing after anterior cruciate ligament (ACL) reconstruction with anteromedial and central femoral tunnel placement.

Methods

During 2016 and 2018, 110 consecutive patients underwent single bundle ACL reconstruction; 85 patients met the inclusion criteria, and each patient underwent 3D-CT within 1 week and MRI 1.5 years after the operation. The central point of the femoral tunnel and signal/noise quotient (SNQ) of three regions of interest (ROI) in the intra-articular graft were measured to analyse the tunnel position and graft healing extent. Clinical assessments, including functional scores, KT-2000 arthrometer measurements and pivot-shift tests, were evaluated at the 2-year follow-up. Patients were divided into two groups depending on the femoral tunnel position: the anteromedial position group (Group A) and the centre position group (Group B).

Results

Seventy-one patients were available for the 2-year follow-up and MRI examination: 34 patients in Group A and 35 patients in Group B, and 2 patients were excluded for an eccentric tunnel position. No graft failure occurred, and compared with the preoperative assessment outcomes, the outcomes of both groups improved at the final follow-up. Group A was significantly better than Group B regarding the KT-2000 arthrometer measurements (P = 0.031). No significant differences were observed in terms of functional scores, pivot-shift test results, or the SNQ between groups.

Conclusions

No differences in clinical outcomes or graft healing were found between AM and central femoral tunnel placements in single bundle ACL reconstruction. Therefore, satisfactory clinical outcomes, knee stability and graft healing can be obtained for both femoral tunnel placements.

Level of evidence

II.

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Funding

This work was supported by grants from the Beijing Municipal Science and Technology Commission No. Z171100001017085, Major Clinic Project of Peking University Third Hospital No. BYSY2018005 and Capital Characteristic Clinic Project No. Z161100000516034.

Author information

Author notes

  1. Jiahao Zhang and Yong Ma contributed equally to this work, and they are co-first authors.

Authors and Affiliations

  1. Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, NO. 49 North Garden Road, Haidian District, Beijing, 100191, People’s Republic of China

    Jiahao Zhang, Yong Ma, Haijun Wang, Yanfang Jiang & Yingfang Ao

  2. Department of Radiology, Peking University Third Hospital, NO. 49 North Garden Road, Haidian District, Beijing, 100191, People’s Republic of China

    Chaonan Pang

Authors
  1. Jiahao Zhang
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Correspondence to Yingfang Ao.

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All the authors declare that they have no conflict of interest.

Ethical approval

This study's design was reviewed and approved by medical science research ethics committee of Peking University Third Hospital, ethics approval number was IRB00006761-2016139.

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Zhang, J., Ma, Y., Pang, C. et al. No differences in clinical outcomes and graft healing between anteromedial and central femoral tunnel placement after single bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 29, 1734–1741 (2021). https://doi.org/10.1007/s00167-020-06206-y

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  • DOI: https://doi.org/10.1007/s00167-020-06206-y

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