Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o'clock and 10 o'clock femoral tunnel placement

Loh, John C.; Fukuda, Yukihisa; Tsuda, Eiichi; Steadman, Richard J.; Fu, Freddie H.; Woo, Savio L‐Y.

doi:10.1053/jars.2003.50084

Cited by 661 publications

(618 citation statements)

References 24 publications

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“…An anteriorly oriented graft does not restore the oblique orientation of the ACL and has limited ability to restore normal knee stability [30,44]. Recent cadaver studies have suggested a graft placed near the center of the ACL more closely restores knee kinematics than an anteriorly placed graft [35,44]. Therefore, anatomic graft placement is likely important given the inability of current reconstruction techniques to restore normal kinematics and is believed an important factor contributing to the long-term development of osteoarthritis after ACL reconstruction [17,39,48,50].…”

Section: Discussionmentioning

confidence: 99%

“…Cadaver studies suggest that placing the graft closer to the center of the attachment site might improve knee kinematics compared with an anterior graft placement. For example, several cadaver studies reported placement of the graft in a more oblique or lateral position improves rotatory knee stability [35,44,52]. One of these studies reported that under rotary loads, an oblique, anatomically placed single-bundle graft reproduced intact knee kinematics, whereas a more vertically oriented graft did not [44].…”

Section: Discussionmentioning

confidence: 99%

“…Anteriorly placed grafts may lead to notch impingement or graft stretching [25,37,56]. Several biomechanical studies show tunnels placed at the 11 o'clock position restore anterior tibial stability under anterior tibial loads but fail to control rotational stability [35,44]. In addition, a graft placed too far anteriorly could result in a vertically oriented graft [5,9,16,25,29,56].…”

Section: Discussionmentioning

confidence: 99%

“…placed near the center of the ACL attachment site on the femur more closely restore normal knee translation and rotation than a more vertically oriented graft [30,35,44].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

140

143

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Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 ± 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 ± 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…placed near the center of the ACL attachment site on the femur more closely restore normal knee translation and rotation than a more vertically oriented graft [30,35,44].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

140

143

View full text Add to dashboard Cite

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“…The neoligament results in a horizontalized position, thus providing greater anteroposterior and rotational stability (15,16) and biomechanical performance (16)(17)(18) , and minimizing occurrences of future osteoarthrosis (5,6) .…”

Section: Risks and Consequences Of Acl Reconstructionmentioning

confidence: 99%

Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral

Astur¹,

Aleluia²,

Santos³

et al. 2012

Rev. bras. ortop.

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Objective: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. Methods: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. Results: The measure of the analysed distances show us an aproximation between Rev Bras Ortop. 2012;47(5):606-10

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Side Variations of Anterior Cruciate Ligament Coronal Angles: Implications for ACL Reconstruction

et al. 2019

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Current literature has shown a biomechanical advantage of recreating the native coronal obliquity of the anterior cruciate ligament (ACL) during grating procedures; however, the majority of studies on ACL morphological variation have been performed unilaterally. This cadaveric study aimed to evaluate sided ACL coronal angle of inclination variation including trend analysis with sex, age, height, and femoral condyle width. The ACLs of 57 embalmed cadaveric specimens were evaluated bilaterally for a total of 114 ACLs. The knees were flexed to 110 . A 0.70-mm wire measured coronal angulation through the lateral tibial plateau and the medial ACL border. An image taken of the wire allowed digital measurement with the ImageJ software. IBM SPSS was utilized for statistical analysis. Bilateral measurements demonstrated a difference in an individual's sided ACL angulation (P < 0.001). Right-sided angulation was greater in 61.4% (35/57). In cadavers with greater right-side angulation, right ACLs averaged 66.2 versus left ACLs averaged 60.9 (P < 0.001). Cadavers with greater leftsided ACL angles demonstrated average left ACLs measuring 65.5 versus right ACLs measuring 60.6 (P < 0.001). Right-sided angles were greater in 69.7% of females. Understanding the anatomy of the ACL's native coronal angle and variations between a patient's knees is imperative during reconstruction surgery to aid in anatomic tunnel placement for improved knee motion and rotational knee kinematics following surgery. A statistically significant difference exists between an individual's right and left ACL coronal angles of inclination.

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Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o'clock and 10 o'clock femoral tunnel placement

Cited by 661 publications

References 24 publications

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral

Side Variations of Anterior Cruciate Ligament Coronal Angles: Implications for ACL Reconstruction

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