Double-Bundle Anterior Cruciate Ligament Reconstruction: A Cadaveric Study on the Posterolateral Tunnel Position and Safety of the Lateral Structures

O comprimento dos túneis femorais varia com a flexão do joelho na reconstrução anatômica do ligamento cruzado anterior

“…In a general manner, the length of femoral tunnels that are more lateral when drilled through the AM portal is shorter than in tunnels that are more anterior and medial, created via the transtibial route (17) . In three published papers, greater knee flexion at the time of drilling produced longer femoral tunnels.…”

“…In three published papers, greater knee flexion at the time of drilling produced longer femoral tunnels. Neven et al (17) used cadavers and found measurements of between 32 and 44 mm (mean of 36.92 mm) for the PL tunnel, which drilled through a low AM portal at 120° of flexion, measured from inside to outside.…”

The Sagittal Plane Angle and Tunnel-Related Complications in Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Transportal Technique: An In Vivo Imaging Study

“…Farrow and Parker recommended drilling at 110 of knee flexion. In addition, Neven et al 23 reported the anatomic relation between the PL tunnel and lateral structures of the knee using 24 cadaveric knees. Their study showed no increased risk of injuring the LCL during PL tunnel placement in double-bundle ACL reconstruction when performed through a low AM portal at a high flexion angle.…”

“…Many studies on the complications of double-bundle ACL reconstruction using the transportal technique have been reported. [20][21][22][23][24][25] A high flexion angle of the knee joint is usually recommended to avoid transportal techniqueerelated complications. 21 Most studies have reported on the relation between knee flexion angle and risk incidence and have indicated that a lower flexion angle increases the incidence of lateral anatomic structure and cartilage damage.…”

“…21 Most studies have reported on the relation between knee flexion angle and risk incidence and have indicated that a lower flexion angle increases the incidence of lateral anatomic structure and cartilage damage. 20,21,[23][24][25] These studies used cadavers and Sawbones models (Sawbones, Malmo, Sweden). However, no in vivo study has analyzed the relation of sagittal plane tunnel positions to complications related to ACL reconstruction using the transportal technique.…”