Radiographic evaluation of anterior cruciate ligament graft failure with special reference to tibial tunnel placement

Almekinders, Louis C.; Chiavetta, John B.; Clarke, John P.

doi:10.1016/s0749-8063(98)70042-8

Cited by 55 publications

(39 citation statements)

References 20 publications

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“…Appropriate placement of the tibial and femoral tunnels is the most important surgical factor for successful anterior cruciate ligament (ACL) reconstruction [ 1 – 6 ]. However, the ideal tunnel position during ACL reconstruction remains an ongoing debate.…”

Section: Introductionmentioning

confidence: 99%

Variations in sagittal locations of anterior cruciate ligament tibial footprints and their association with radiographic landmarks: a human cadaveric study

Cho

Kim

Kang

et al. 2017

BMC Musculoskelet Disord

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BackgroundThis cadaveric study aimed to demonstrate variation of the anterior cruciate ligament (ACL) tibial attachment in the sagittal plane, and to analyze the radiographic landmarks which predict the sagittal location of the ACL tibial attachment.MethodsIn 20 cadaveric knees, native ACLs were removed and the centers of the ACL tibial and femoral attachments were marked with metal pins. Full extension lateral radiographs were then obtained in each cadaveric knee. Using the full extension lateral radiographs, the sagittal location of the ACL tibial footprint center was estimated as a percentage in the Amis and Jakob’s line. Several radiographic landmarks including the geometry of Blumensaat’s line and the apex of the tibial eminence were measured. Then, the relationship between the variation of the sagittal location of the ACL tibial footprint and several radiographic landmarks were analyzed using Pearson’s correlation analysis.ResultsThe average sagittal position of the native ACL tibial footprint was 40.9% (range: 38.0–45.0%). The line connecting the centers of the ACL footprint was nearly parallel to Blumensaat’s line, with an average angle of 1.7° (range: 0–4.1°). In addition, the distance from the point where Blumensaat’s line meets the tibial articular surface to the center of the ACL tibial footprint was almost consistent, at 7.6 mm on average (range: 6.4–8.7 mm). The correlation analysis revealed that the geometry of Blumensaat’s line was significantly correlated with the sagittal location of the ACL tibial footprint.ConclusionThe radiographic landmark that showed a significant correlation with the ACL tibial footprint in the full extension lateral radiographs was Blumensaat’s line.

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Section: Introductionmentioning

confidence: 99%

Variations in sagittal locations of anterior cruciate ligament tibial footprints and their association with radiographic landmarks: a human cadaveric study

Cho

Kim

Kang

et al. 2017

BMC Musculoskelet Disord

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show abstract

“…Such techniques have been extensively used in previous studies. [11][12][13][14][15] However, only indirect measurement of tunnel placement may be performed on plain radiographs because the intra-articular tunnel opening is difficult to accurately define on plain radiographs, especially on the femoral side. Furthermore, the relative measurement of the location of the tunnel opening may be flawed by an inadequate position of the knee, especially in rotation, or poor beam orientation.…”

Section: Discussionmentioning

confidence: 99%

Navigated Anterior Cruciate Ligament Reconstruction: Radiographic Validation of a Nonimage-based System

Jenny¹,

Abane²

2012

Orthopedics

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The authors compared the intraoperative navigated measurements of the location of the tibial and femoral tunnels during arthroscopic-assisted anterior cruciate ligament reconstruction to the postoperative measurements performed on standard plain radiographs in 56 patients. The position of the center of the tibial and femoral tunnels was measured intraoperatively with the OrthoPilot (B. Braun Aesculap, Tuttlingen, Germany) and postoperatively on plain anteroposterior and lateral radiographs. The center of the tibial tunnel was located at 43% of the mediolateral tibial dimension intraoperatively and at 41% of the mediolateral tibial dimension postoperatively (P=.14). The center of the tibial tunnel tibial was located at 40% of the anteroposterior tibial dimension intraoperatively and at 35% of the anteroposterior tibial dimension postoperatively (P=.01). The center of the femoral tunnel was located at 85% of the anteroposterior femoral dimension intraoperatively and at 76% of the anteroposterior femoral dimension postoperatively (P<.001). A significant correlation was found between intraoperative navigated and postoperative radiographic measurements only at the femur. Good agreement existed between all navigated and radiographic measurements. The OrthoPilot navigation system allows an accurate measurement of the location of the tibial and femoral tunnels during anterior cruciate ligament reconstruction.

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“…26 The tibial graft position was measured using the method described by Frank et al 12 and was similar to previously published methods. 2 With use of the anterior cortex of the tibia as a reference, the anterior and posterior margins of the graft were measured and divided by 2 to determine the center of the graft position ( Figure 3). The total width of the tibia was measured from the anterior cortex to the posterior cruciate ligament insertion.…”

Section: Methodsmentioning

confidence: 99%

A Radiographic Assessment of Failed Anterior Cruciate Ligament Reconstruction

Waltz¹,

Solomon

Provencher

2014

Am J Sports Med

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Radiographic evaluation of anterior cruciate ligament graft failure with special reference to tibial tunnel placement

Cited by 55 publications

References 20 publications

Variations in sagittal locations of anterior cruciate ligament tibial footprints and their association with radiographic landmarks: a human cadaveric study

Variations in sagittal locations of anterior cruciate ligament tibial footprints and their association with radiographic landmarks: a human cadaveric study

Navigated Anterior Cruciate Ligament Reconstruction: Radiographic Validation of a Nonimage-based System

A Radiographic Assessment of Failed Anterior Cruciate Ligament Reconstruction

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