Limited accuracy of transtibial aiming for anatomical femoral tunnel positioning in ACL reconstruction.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-02-10 DOI:10.1051/sicotj/2025002
Dimitrios Mastrokalos, Anastasios G Roustemis, Dimitrios Koulalis
{"title":"Limited accuracy of transtibial aiming for anatomical femoral tunnel positioning in ACL reconstruction.","authors":"Dimitrios Mastrokalos, Anastasios G Roustemis, Dimitrios Koulalis","doi":"10.1051/sicotj/2025002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) rupture is a common knee injury, and with advancements in knee arthroscopy, ACL reconstruction has become common. Techniques like single-double bundle and femoral tunnel drilling via transtibial or anteromedial portal approaches are available. This study evaluates the accuracy of femoral tunnel placement via these approaches in single-bundle ACL reconstruction.</p><p><strong>Materials and methods: </strong>Forty-three ACL reconstructions using hamstring grafts were analyzed. Initially, femoral tunnels were drilled via the anteromedial portal from 09:30 to 10:00 (14:00 to 14:30 for left knees). Tibial tunnels (mean anteroposterior angle: 63.5°, sagittal: 64.2°) were then created with the same diameter, accompanied by radiological documentation. A femoral aiming device was used to place a K-wire at the center of the femoral tunnel, recorded photographically. Tunnel diameters included 7 mm (20 cases), 7.5 mm (11 cases), 8 mm (7 cases), 8.5 mm (3 cases), and 9 mm (1 case). Two observers evaluated all radiological and photographic data, focusing on the deviation of the transtibial K-wire from the femoral tunnel center.</p><p><strong>Results: </strong>Of 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.</p><p><strong>Conclusion: </strong>Transtibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"8"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809194/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"SICOT-J","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1051/sicotj/2025002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/10 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Anterior cruciate ligament (ACL) rupture is a common knee injury, and with advancements in knee arthroscopy, ACL reconstruction has become common. Techniques like single-double bundle and femoral tunnel drilling via transtibial or anteromedial portal approaches are available. This study evaluates the accuracy of femoral tunnel placement via these approaches in single-bundle ACL reconstruction.

Materials and methods: Forty-three ACL reconstructions using hamstring grafts were analyzed. Initially, femoral tunnels were drilled via the anteromedial portal from 09:30 to 10:00 (14:00 to 14:30 for left knees). Tibial tunnels (mean anteroposterior angle: 63.5°, sagittal: 64.2°) were then created with the same diameter, accompanied by radiological documentation. A femoral aiming device was used to place a K-wire at the center of the femoral tunnel, recorded photographically. Tunnel diameters included 7 mm (20 cases), 7.5 mm (11 cases), 8 mm (7 cases), 8.5 mm (3 cases), and 9 mm (1 case). Two observers evaluated all radiological and photographic data, focusing on the deviation of the transtibial K-wire from the femoral tunnel center.

Results: Of 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.

Conclusion: Transtibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.

前交叉韧带重建中经胫目的股骨隧道解剖定位的准确性有限。
背景:前交叉韧带(ACL)断裂是一种常见的膝关节损伤,随着膝关节镜技术的进步,ACL重建已经变得很常见。通过胫骨或前内侧门静脉入路进行单双束和股骨隧道钻孔等技术是可行的。本研究评估在单束前交叉韧带重建中通过这些入路置入股骨隧道的准确性。材料与方法:对43例腘绳肌腱重建前交叉韧带进行分析。最初,从09:30至10:00(左膝14:00至14:30)通过前内侧门静脉钻取股骨隧道。胫骨隧道(平均前后角:63.5°,矢状角:64.2°)直径相同,并附有影像学记录。使用股骨瞄准装置在股骨隧道中心放置k线,照相记录。隧道直径包括7mm(20例)、7.5 mm(11例)、8mm(7例)、8.5 mm(3例)和9mm(1例)。两名观察员评估了所有的放射学和摄影资料,重点是胫骨k针与股骨隧道中心的偏离。结果:38例患者中,11例(28.9%)经胫k线位于股骨隧道内,其中7例直径为7mm, 2例直径为7.5 mm和8mm。在23例(60.5%)患者中,k线位于股骨隧道周边或外侧,其中11例直径为7mm, 8例为7.5 mm, 4例为8mm, 3例为8.5 mm, 1例为9mm。结论:经胫骨瞄准股骨隧道解剖定位具有挑战性。胫骨偏度与胫骨隧道直径无明显相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信