2010
DOI: 10.1007/s00167-010-1183-4
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Tunnel positioning in anterior cruciate ligament reconstruction: how long is the learning curve?

Abstract: The purpose of this study is to investigate the effect of the learning curve on radiographic tunnel position. A consecutive series of the first 200 procedures of an orthopaedic surgeon over his initial 4years of independent practice were analysed for tunnel placement, based on radiographic appearance. An arthroscopic-assisted technique using patella tendon as graft material was performed in all cases. To establish femoral tunnels, a transtibial guide pin was used. The graft was secured with bioabsorbable screw… Show more

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Cited by 24 publications
(12 citation statements)
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“…There is certainly a learning curve, however, so surgeons must pay careful attention while learning this new technique. 22,33,49 Long-term clinical studies evaluating outcomes with this technique and comparing those with outcomes of other techniques are needed. This study demonstrates that use of an accessory medial portal will facilitate more accurate placement of the femoral tunnel in the native ACL femoral footprint and thus should improve the ability to achieve a more anatomic reconstruction of the ACL.…”
Section: Discussionmentioning
confidence: 99%
“…There is certainly a learning curve, however, so surgeons must pay careful attention while learning this new technique. 22,33,49 Long-term clinical studies evaluating outcomes with this technique and comparing those with outcomes of other techniques are needed. This study demonstrates that use of an accessory medial portal will facilitate more accurate placement of the femoral tunnel in the native ACL femoral footprint and thus should improve the ability to achieve a more anatomic reconstruction of the ACL.…”
Section: Discussionmentioning
confidence: 99%
“…All patients underwent surgical reconstruction by a single fellowship trained experienced knee surgeon using an arthroscopic assisted ACL-reconstruction utilizing the central third of the patellar tendon and interference screws as described previously [14]. Post-operatively, the extremity was placed into a ROM brace for six weeks.…”
Section: Surgical Procedures and Rehabilitationmentioning
confidence: 99%
“…Care must be taken to protect the medial meniscus and medial femoral condyle while inserting instruments from the medial portal. [7][8][9] There is a concern that drilling an independent femoral tunnel through a medial portal may lead to a shorter femoral tunnel and an increased risk of blowout fracture of the posterior wall of the lateral femoral condyle. 10 Thus, the knee should be kept in maximal hyperflexion during femoral tunnel drilling.…”
mentioning
confidence: 99%