Impact of Tibial and Femoral Tunnel Position on Clinical Results After Anterior Cruciate Ligament Reconstruction

Sadoghi, Patrick; Kröpfl, A.; Jansson, Volkmar; Müller, Peter E.; Pietschmann, Matthias F.; Fischmeister, M. F.

doi:10.1016/j.arthro.2010.08.015

Cited by 125 publications

(116 citation statements)

References 32 publications

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“…Patient reported outcome measures have been previously reported to be improved with an anatomic ACL reconstruction [33]. The lack of a difference in this study, despite kinematic differences and evidence of early cartilage degeneration, could be due to an inability of these subjective outcome measures to reflect early differences.…”

Section: Discussionmentioning

confidence: 67%

A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

et al. 2015

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Introduction Multiple techniques are used for femoral tunnel drilling in ACL reconstruction, including the Mini-Two Incision method (MT) and Anteromedial Portal technique (AM). Both techniques allow for independent placement of the femoral tunnel, though there are no reports comparing kinematics and cartilage health after these reconstructions. We hypothesized that both techniques would result in the restoration of normal knee kinematics and show no evidence of early cartilage degeneration. Methods A total of 20 patients were evaluated one year after ACL reconstruction, including 10 patients after MT and 10 patients after AM. MR-imaging was acquired bilaterally with the knee loaded in extension and flexion to evaluate kinematics of the reconstructed knee compared to the normal knee. Quantitative cartilage imaging was obtained and compared to 10 matched control subjects. The Marx Activity Rating Scale and KOOS survey were administered. Results The tibia was positioned significantly more anteriorly in extension and flexion relative to the contralateral knee for the MT group. The tibial position in the AM group was not significantly different from the patient’s contralateral knee. T1ρ values in the central-medial tibia were significantly elevated in the MT group compared to the Control group. KOOS Symptom scores were significantly better for the MT group compared to the AM group. Conclusions We have observed in vivo differences in knee kinematics and early cartilage degeneration between patients following MT and AM ACL reconstruction. Both techniques allow for anatomic ACL reconstruction, though the MT group shows significant early differences compared to the patient’s normal knee.

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Section: Discussionmentioning

confidence: 67%

A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

et al. 2015

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“…33,34 A number of researchers have suggested that anteromedial approaches or outside-in approaches (or both) can yield tunnels in more anatomic positions than transtibial approaches. [35][36][37][38][39][40][41][42] In an anatomic study of ACL attachment locations using 20 human cadaveric knees, Zantop et al 25 reported that the center of the femoral AM bundle was located along the Blumensaat line at a distance of 18.5% of the sagittal diameter of the femur and at 22.3% of the height measured perpendicular to the Blumensaat line.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Study of the Outcome of a New Instrument for All-Inside Double-Bundle Anterior Cruciate Ligament Reconstruction

Watanabe

Takahashi

Hino

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Sadoghi et al (2011) found significantly superior clinical outcome in anatomical ACL reconstructions in both techniques in terms of higher clinical scores, higher anterior-to-posterior stability, and less pivot shift.…”

Section: Introductionmentioning

confidence: 91%

Different Techniques of ACL Reconstruction: Guidelines

Petersen¹

2014

Sports Injuries

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Anatomical ACL replacement with medial portal drilling and footprint reconstruction is the technique of choice for patients with symptomatic instability after an ACL rupture (non-coper). The gold standard is the anatomic single-bundle reconstruction with mid-position placement of the tunnel. For patients with a large attachment area, a double-bundle technique could be indicated. Graft options for anatomical ACL reconstruction are the hamstrings, patellar tendon, or the quadriceps tendon with or without bone blocks. Graft choice depends on the individual demands and needs of the patient. A large group of patients can be treated successfully by all three autografts or by nonirradiated allografts. Some subgroups, however, may profit from a specific graft choice. Age, gender, activity, sports, profession, and religious habits should be considered.

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Impact of Tibial and Femoral Tunnel Position on Clinical Results After Anterior Cruciate Ligament Reconstruction

Cited by 125 publications

References 32 publications

A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

Short-Term Study of the Outcome of a New Instrument for All-Inside Double-Bundle Anterior Cruciate Ligament Reconstruction

Different Techniques of ACL Reconstruction: Guidelines

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