Failure of reconstruction of the anterior cruciate ligament due to impingement by the intercondylar roof.

Howell, Stephen M.; Taylor, Michael Alan

doi:10.2106/00004623-199307000-00011

Cited by 326 publications

(243 citation statements)

References 20 publications

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“…The medial and lateral limits of the attachment were at -3±1[-5-(-2)] mm and +6±2 (3)(4)(5)(6)(7)(8)(9) mm respectively lateral to the medial tibial spine. The tibial attachment was on average 17±2(12-19) mm long and 9±2(7-16) mm wide.…”

Section: Resultsmentioning

confidence: 99%

“…Despite the range of grafts and fixation devices employed, correct tunnel placement remains the main determinant of the final outcome 6,7 and a malpositioned tunnel is likely to result in instability or in lack of recovery of the range of motion 8,9,10,11 . An anatomic position of the graft is desirable but identifying the correct tunnel exit point within the whole attachment area of the ACL may be a challenge.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

Cuomo

Edwards

Giron

et al. 2006

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

Cuomo

Edwards

Giron

et al. 2006

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Since good clinical results after ACL reconstruction have been reported in literature, it was decided to study the anatomic tunnel placement using knee sagittal radiographs. [7][8][9][10] If an anterior positioning in the sagittal plane is performed, an impingement in the intercondylar roof may occur. Similarly, if the positioning is too posterior in the sagittal plane, it may result in loss of knee flection and higher tear rate.…”

Section: Discussionmentioning

confidence: 99%

Tibial tunnel positioning on lateral radiographs in anterior cruciate ligament reconstruction: a single surgeon experience

Silva¹,

Maia

Ferreira

et al. 2017

Int J Res Orthop

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INTRODUCTIONCorrect tunnel positioning in anterior cruciate ligament (ACL) reconstruction surgery is one of the keystones for success and is still an important question among orthopedic surgeons. However, the correct location of the femoral and tibial tunnels is still controversial and target of disagreement within the scientific literature. The known problems include femoral notch impingement and graft versus posterior cruciate ligament (PCL) impingement. Fortunately, tibial tunnel placement error has less negative impact in graft function than the femoral tunnel and probably, by this reason, the impact in the literature regarding this subject is less common.1 To achieve optimal surgical performance the surgeon requires practice and continuous execution of the surgical procedure.2 Therefore, it was decided to study the tibial tunnel placement in ACL reconstruction surgeries of a single surgeon in his first 32 cases during a 6 years period in order to identify a correlation between the number of cases performed by year and the correct placement of the tunnel, as well as, the evolution along the years on the positioning. METHODSIt was retrospectively analyzed the radiographs of 32 patients submitted to ACL reconstruction surgery by a single senior surgeon (LC) between 2009 and 2015 (these were the first cases performed by the surgeon with ABSTRACT Background: Accurate tunnel positioning in anterior cruciate ligament reconstruction surgery is one of the cornerstones for its success. However, it is still controversial and target of disagreement within the orthopedic literature. Therefore, it was aimed to evaluate the tibial tunnel placement in anterior cruciate ligament reconstruction surgeries of a single orthopedic surgeon. Methods:The postoperative knee sagittal radiographs of anterior cruciate ligament reconstructed knees from a single surgeon were retrospectively collected. To assess the tunnel positions was used predefined criteria (in percentage and in millimeters) within the intervals found in the literature (41-43 percent and 21-23 millimeters). Results: There were no significant differences between the number of results (% and mm), within and without the intervals that were considered acceptable for this measure (P >0.05). It was found significant differences in the absolute deviation (%) throughout non-consecutive years (P <0.05). There was no correlation between the absolute deviations and the years of experience (r =-0.080, P =0.663). Conclusions: Significant differences were found in the absolute deviation (%) throughout non-consecutive years, suggesting variations in the tunnel position throughout the years.

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“…ACL reconstruction is one of the most common orthopaedic procedures in North America [18], and multiple studies have demonstrated that correct tunnel placement is a key factor for a successful clinical outcome [19][20][21][22]. Considerable variation in tunnel placement has been reported with conventional techniques [23,24], and up to 80 % of complications are related to malpositioned tunnels [25].…”

Section: Anterior Cruciate Ligament Reconstructionmentioning

confidence: 99%

“…In theory, this allows the surgeon to increase accuracy by choosing more optimal tunnel positions. However while graft impingement has been associated with poorer clinical outcome [19], the effect of isometry is more controversial. Some authors recommend an isometric area for ACL placement, whereas others feel that graft isometry has little effect on clinical outcome [10,33,34].…”

Section: Anterior Cruciate Ligament Reconstructionmentioning

confidence: 99%

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

Young

Safran

Clatworthy³

2013

Curr Rev Musculoskelet Med

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Computer-assisted surgery (CAS) has been investigated in a number of sports medicine procedures in the knee. Current barriers to its widespread introduction include increased costs, duration, and invasiveness of surgery. Randomized trials on the use of CAS in anterior cruciate ligament reconstruction have failed to demonstrate a clinical benefit. Data on CAS use in high tibial osteotomy are more promising; however, long-term studies are lacking. CAS has a number of research applications in knee ligament surgery, and studies continue to explore its use in the treatment of osteochondral lesions. This article reviews the applications of CAS in sports medicine knee surgery and summarizes current literature on clinical outcomes.

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Failure of reconstruction of the anterior cruciate ligament due to impingement by the intercondylar roof.

Cited by 326 publications

References 20 publications

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

Tibial tunnel positioning on lateral radiographs in anterior cruciate ligament reconstruction: a single surgeon experience

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

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