Femoral Tunnel Length: Accessory Anteromedial Portal Drilling Versus Transtibial Drilling

Ilahi, Omer A.; Ventura, N.; Qadeer, Amad A.

doi:10.1016/j.arthro.2011.09.018

Cited by 32 publications

(25 citation statements)

References 18 publications

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“…Currently, OI and TP techniques are popular techniques for drilling femoral tunnels in anatomic ACL reconstruction [8,9,12,20,25,29,30,32,34,51,54,56], and modified TT technique has been also reported to achieve anatomic placement of the grafts within ACL footprint [14,58,59]. Recent studies on GBA evaluated by postoperative CT have reported that OI technique resulted in more steep GBA than in TP technique, with about 80° GBA by OI technique [23,40,50], and these results were similar to our findings at full extension.…”

Section: Discussionsupporting

confidence: 58%

Comparison of graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

Tashiro

Irarrázaval

Osaki

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionsupporting

confidence: 58%

Comparison of graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

Tashiro

Irarrázaval

Osaki

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…10 Thus, the knee should be kept in maximal hyperflexion during femoral tunnel drilling. 2 In studies assessing the femoral tunnel length created through an accessory medial portal, 4,11,12 only one attempted to correlate it with various anthropometric variables (body height, body weight, and body mass index). 4 This study measured the femoral tunnel length created through a far medial portal and determined its correlation with body height, limb length, and thigh length in 404 Indian patients.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Femoral Tunnel Length with Body Height, Limb Length, and Thigh Length in Indian Patients Undergoing Anterior Cruciate Ligament Reconstruction

Gupta

Malhotra

Kumar

et al. 2016

J Orthop Surg (Hong Kong)

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Purpose. To measure the femoral tunnel length created through a far medial portal and determine its correlation with body height, limb length, and thigh length in 404 Indian patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods. 364 male and 40 female Indian patients aged 18 to 51 (mean, 26.8) years underwent ACL reconstruction by a single surgeon using the hamstrings tendon autograft. Their body height, limb length, and thigh length were measured by a single assessor, as was the femoral tunnel length. Results. The mean femoral tunnel length was 34.5 mm. It was <30 mm in 28 patients and <25 mm in 2 patients. The correlation coefficients of the femoral tunnel length with body height, limb length, and thigh length were 0.485 (p<0.0001), 0.426 (p<0.0001), and 0.304 (p<0.0001). No patient had posterior wall blowout fracture. Conclusion. The femoral tunnel length positively correlated with body height, limb length, and thigh length in 404 Indian patients.

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“…A recent clinical trial has also found a tendency for shorter tunnels with use of the AM portal technique15). In a study of post-operative CT scans following double bundle ACL reconstruction, a femoral tunnel of less than 30 mm was found to develop in some cases16).…”

Section: Discussionmentioning

confidence: 99%

Determinants of Femoral Tunnel Length in Anterior Cruciate Ligament Reconstruction: CT Analysis of the Influence of Tunnel Orientation on the Length

Iyyampillai

Raman

Rajan

et al. 2013

Knee Surg Relat Res

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PurposeThe purpose of the study was to identify the femoral tunnel orientation that consistently results in a tunnel length of more than 35 mm in anterior cruciate ligament reconstruction.Materials and MethodsComputed tomography (CT) scans were obtained from 30 patients who did not have any pathology in the distal femur. Virtual tunnels were marked on 3D (3-dimensional) reconstructed CT images after determining the orientation defined by sagittal inclination and axial angle. The length of a femoral tunnel in 64 different combinations of orientations (between 30° and 65° in 5° increments in two planes) was measured on 3D reconstructed images in both knees in 30 patients. Reliability of measurement was assessed with correlation coefficient for intra-observer and inter-observer measurements. A one-way analysis of variance (ANOVA) was used for statistical analysis.ResultsThe mean femoral tunnel length varied significantly with each 10° change in orientation in both planes (p<0.05, ANOVA). A femoral tunnel of more than 35 mm in length could be obtained only with a sagittal inclination of more than 50° and axial angle of 30°-45°. When the axial angle was kept constant, the tunnel length increased with the increase in sagittal inclination. Higher sagittal inclinations consistently resulted in longer tunnels (r>0.9) and reduced the incidence of posterior cortical breakage.ConclusionsA tunnel orientation with an axial angle between 30°-45° and a sagittal inclination of more than 50° can result in a tunnel length of more than 35 mm.

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Femoral Tunnel Length: Accessory Anteromedial Portal Drilling Versus Transtibial Drilling

Cited by 32 publications

References 18 publications

Comparison of graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

Comparison of graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

Correlation of Femoral Tunnel Length with Body Height, Limb Length, and Thigh Length in Indian Patients Undergoing Anterior Cruciate Ligament Reconstruction

Determinants of Femoral Tunnel Length in Anterior Cruciate Ligament Reconstruction: CT Analysis of the Influence of Tunnel Orientation on the Length

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