The use of a mono-fluted reamer results in decreased enlargement of the tibial tunnel when using a transtibial ACL reconstruction technique

Knight, Justin R.; Condie, Daniel; Querry, R. G.; Robertson, William J.

doi:10.1007/s00167-013-2455-6

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…A further study demonstrated differences in tibial tunnel deformation between reamer designs when reaming the femoral tunnel if a transtibial technique is used. 4 In our study, we noted that the dimensions of the tibial tunnel's outer aperture vary relative to the reamer's diameter, even when reaming was performed in line with the guidewire. We believe the likely explanation is that the reamer penetrates the outer cortical surface at an angle rather than perpendicular to it.…”

Section: Discussionmentioning

confidence: 71%

“…A further study demonstrated differences in tibial tunnel deformation between reamer designs when reaming the femoral tunnel if a transtibial technique is used. 4…”

Section: Discussionmentioning

confidence: 99%

“…Some of the effects of these design differences have been previously reported, but additionally, we note that as the working length varies between the two reamers, angulation of these may effect on the outer aperture of the tibial tunnel in different ways. 3,4 To the best of our knowledge, the effect of reamer design on the size and shape of the distal tibial aperture has not been previously reported and the aim of our study was to assess this.…”

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confidence: 97%

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confidence: 99%

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Comparison of Acorn and Fluted Reamers on Tibial Tunnel Outer Aperture Dimensions in Anterior Cruciate Ligament Reconstruction

et al. 2020

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The aim of this study was to determine if the type of reamer used in tibial tunnel creation during anterior cruciate ligament (ACL) reconstruction influences the dimensions of the tunnel's outer aperture. Tibial tunnels were created in tibial saw bones by reaming over a guidewire using an 8 mm acorn or fluted reamer in an antegrade manner. Reaming was aimed either in line with the guidewire, or with 10-degree inferior/superior deviation in relation to the wire. The shape and size of the outer aperture of the tibial tunnel were compared between the two reamers. When using the acorn reamer, a 10-degree deviation in relation to the guidewire resulted in minimal change in outer aperture length (mean 13.6 vs. 15.6 mm, p = 0.11) and width (11.6 vs. 11.1 mm, p = 0.51). However, when using the fluted reamer, although the aperture width showed no substantial change with reamer/guidewire deviation (11.4 vs. 11.2 mm, p = 0.71), the mean length almost doubled (14.7 vs. 28.1 mm, p = 0.002). The use of a fluted reamer when reaming the tibial tunnel creates a distal aperture which is inconsistently sized, larger, and of oblong shape compared with an acorn-shaped reamer. This should be taken in consideration when using a fluted reamer for creating the tibial tunnel in ACL reconstruction.

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Section: Discussionmentioning

confidence: 71%

“…A further study demonstrated differences in tibial tunnel deformation between reamer designs when reaming the femoral tunnel if a transtibial technique is used. 4…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

mentioning

confidence: 99%

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Comparison of Acorn and Fluted Reamers on Tibial Tunnel Outer Aperture Dimensions in Anterior Cruciate Ligament Reconstruction

et al. 2020

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“…This result indicates that those cases could incur damage to the MFC. A mono-fluted reamer 35 with an eccentric mono-fluted cutting edge and narrow shaft is useful to make the femoral tunnel and prevent MFC damage. We used the Sentinel cannulated reamer to prevent damage to the MFC cartilage.…”

Section: Complications Of Transportal Techniquementioning

confidence: 99%

The Sagittal Plane Angle and Tunnel-Related Complications in Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Transportal Technique: An In Vivo Imaging Study

Park

Moon

Lee

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Optimal angles for independent femoral tunnel drillings to prevent damage to anatomic structures in single-bundle anterior cruciate ligament reconstruction

Huang,

Zhang,

Zhang

et al. 2024

J Orthop Surg Res

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Purpose To determine the optimal angles for independent femoral tunnel drillings in single-bundle anterior cruciate ligament reconstruction (ACLR) in different races and genders with the aim of preventing damage to lateral femoral anatomic structures (LFAS), posterior cortex and medial femoral condyle. Methods This study included 180 volunteers, including 90 Caucasian and 90 matched Chinese. Magnetic resonance imaging (MRI) was used to scan the knees to create three-dimensional bone models, the ACL femoral footprint centre and the LFAS. In each femur model, femoral tunnels were established using a set of 16 distinct angular combinations: 15°, 30°, 45°, and 60° i n the axial plane, as well as 15°, 30°, 45°, and 60° in the coronal plane. The minimum distance from the tunnel exit to the LFAS was evaluated, and the tunnel length, posterior cortex damage and medial femoral condyle injury were assessed. Results Among the 180 patients with simulated ACL femoral tunnels, there was damage to the anatomical structure in parts of the model. According to the Cochran Q test results ( P < 0.001), the percentage of safe tunnels varied significantly among the 16 different drilling angle combinations. The overall occurrence of the tunnel exit causing injury to LFAS were 8.3% and 8.1% in Chinese and Caucasian groups ( P = 0.786). The means for tunnel length in Caucasians was 40.1 ± 7.9 mm, respectively; for Chinese, the results was 38.8 ± 6.6 mm ( P < 0.001). Females had significantly shorter femoral tunnels than males in both Chinese and Caucasian ( P < 0.001). The overall invasion rate of the posterior cortex and medial femoral condyle were 32.6% and 7.4% for Chinese; 31.0% and 7.4% for Caucasians, respectively. Conclusion To reduce risks of injury to anatomical structures, such as the LFAS, posterior cortex and medial femoral condyle, specific angle combinations of 30°/45°, 45°/30°, 45°/45°, 45°/60°, 60°/30°, 60°/45° and 60°/60° should be used when creating the femoral tunnel in single-bundle ACLR. The selected drilling angles are critical for optimizing femoral tunnel placement. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-024-05181-1.

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The use of a mono-fluted reamer results in decreased enlargement of the tibial tunnel when using a transtibial ACL reconstruction technique

Abstract: The use of a mono-fluted reamer for femoral tunnel preparation results in less tibial tunnel deformation during transtibial reaming.

Cited by 4 publications

References 18 publications

Comparison of Acorn and Fluted Reamers on Tibial Tunnel Outer Aperture Dimensions in Anterior Cruciate Ligament Reconstruction

Comparison of Acorn and Fluted Reamers on Tibial Tunnel Outer Aperture Dimensions in Anterior Cruciate Ligament Reconstruction

The Sagittal Plane Angle and Tunnel-Related Complications in Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Transportal Technique: An In Vivo Imaging Study

Optimal angles for independent femoral tunnel drillings to prevent damage to anatomic structures in single-bundle anterior cruciate ligament reconstruction

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