SICOT-J最新文献

{"title":"Safety and outcomes of bikini-incision DAA for hip arthroplasty with large acetabular cups (≥56 mm): A single-surgeon series of 215 cases.","authors":"Fadhil Mat Salleh, Ikram Nizam","doi":"10.1051/sicotj/2025021","DOIUrl":"https://doi.org/10.1051/sicotj/2025021","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates complications associated with the bikini-incision direct anterior approach (DAA) total hip arthroplasty (THA) performed by a single surgeon on a standard operating table, with a focus on cases requiring large acetabular cups (≥56 mm). Secondary objectives include assessing clinical outcomes and implant survivorship.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on primary bikini-incision DAA THAs performed by a single surgeon between 2013 and 2024. Cases involving acetabular cups ≥56 mm were included, while emergency hip fracture cases and those requiring posterolateral approaches were excluded. Clinical data, radiographs, and Kaplan-Meier survival analysis were used to assess complications, Harris Hip Scores (HHS), and implant survivorship.</p><p><strong>Results: </strong>This study included 215 THA procedures performed on 210 male patients (mean age 67 years, BMI 28.6), with an average follow-up of 3.9 years. The primary indication was osteoarthritis (88.4%). The mean preoperative HHS was 41.8, which significantly improved to 92.6 postoperatively (p < 0.001). Complications included lateral femoral cutaneous nerve (LFCN) neuropraxia (2.3%), periprosthetic fractures (0.93%), and femoral stem subsidence (0.93%). The revision rate was 0.93%, with Kaplan-Meier analysis indicating a 99% survival rate for the stem and 100% survival for the acetabular cup at the final follow-up.</p><p><strong>Discussion: </strong>The bikini-incision DAA THA using a standard operating table provides excellent short- to mid-term functional outcomes and implant survivorship for patients requiring large acetabular cups (≥56 mm). The approach is associated with low complication and revision rates, supporting its safety and efficacy in this cohort.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"25"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional \"ear-hand\" dialogue between osteotome and hammer to estimate the elastic modulus of bone.","authors":"Claire Bastard, Guillaume Haiat, Philippe Hernigou","doi":"10.1051/sicotj/2024060","DOIUrl":"10.1051/sicotj/2024060","url":null,"abstract":"<p><strong>Background: </strong>Hinge fracture on the lateral part of the tibia (LHF) is a common complication of medial Open Wedge High Tibial Osteotomy (OWHTO). Many factors have been described as risks for these fractures, but no study has compared an osteotome or an oscillating saw to prevent LHF following OWHTO.</p><p><strong>Methods: </strong>This \"propensity-score-matched\" (PSM) study was conducted from data obtained in the literature from 1974 to November 2024. A total of 10,368 knees with OWHTO were identified. After 1:1 matching based on correction amount, posterior slope change, surgeon's experience, the osteotome and oscillating groups comprised 2760 knees each.</p><p><strong>Results: </strong>Among the 5520 knees of the PSM population, the prevalence of LHF was 6.1% in the osteotome alone group (168 cases), and 22% in the oscillating saw group (607 cases). The osteotome group had a significant lower prevalence of hinge fracture than the oscillating saw group (OR, 0.23; 95% CI, 0.19 to 0.27; p < 0.0001) and a lower rate of clinically relevant hinge fractures with revision (OR, 0.34; 95% CI, 0.25 to 0.45; p < 0.001.</p><p><strong>Discussion: </strong>The osteotome may be an appropriate method for preventing hinge fractures following OWHTO.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"5"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thai version of ACL return to sports after injury scale translated with cross-cultural adaptation provided the good validation in Thai patients who received ACL reconstruction.","authors":"Teerapat Laddawong, Chaiyanun Vijittrakarnrung, Patarawan Woratanarat, Nadhaporn Saengpetch","doi":"10.1051/sicotj/2025009","DOIUrl":"10.1051/sicotj/2025009","url":null,"abstract":"<p><strong>Purpose: </strong>The Anterior Cruciate Ligament Return to Sports after Injury scale (ACL-RSI) has been translated and culturally adapted into the Thai version. This study aimed to evaluate the reliability and validity of the Thai ACL-RSI for athletes recovering from ACL reconstruction.</p><p><strong>Methods: </strong>This study was a cross-sectional study. Forward-backward translation, cultural adaptation, and validation of the Thai ACL-RSI were performed and tested in 40 athletes (8 females, 32 males; mean age 30.2 ± 7.32 years; mean body weight 70.7 ± 13.36 kg; mean height 170.1 ± 6.53 cm; mean body mass index 24.5 ± 3.74 kg/m²; mean time from surgery to evaluation 8.43 ± 1.83 months). Participants completed the translated Thai ACL-RSI and the validated Thai Tampa Scale of Kinesiophobia (TSK). The Thai ACL-RSI underwent content validity, internal consistency, reliability, and construct validity assessment.</p><p><strong>Results: </strong>The Thai ACL-RSI demonstrated commendable content validity (item-objective congruence index [IOC] 0.91), internal consistency (Cronbach's alpha coefficient 0.84), and test-retest reliability (intraclass correlation coefficient [ICC] 0.75). There was a significant negative correlation with TSK (r = -0.67, p < 0.001).</p><p><strong>Conclusion: </strong>The Thai ACL-RSI is validated, reliable, and consistent with the Thai TSK. This instrument can potentially measure psychological factors influencing preparedness for sports participation after ACL reconstruction. The evaluation of return-to-sport readiness should involve a multidisciplinary approach, including surgeons, physiotherapists, and psychologists, to ensure a comprehensive assessment of physical, functional, and psychological factors.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"15"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry.","authors":"Tomoya Masunaga, Shinji Tsukamoto, Kanya Honoki, Hiromasa Fujii, Akira Kido, Manabu Akahane, Yasuhito Tanaka, Andreas F Mavrogenis, Costantino Errani, Akira Kawai","doi":"10.1051/sicotj/2025011","DOIUrl":"10.1051/sicotj/2025011","url":null,"abstract":"<p><strong>Introduction: </strong>Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with a poor prognosis. Treatment for localized DDCS generally involves wide resection; the effectiveness of adjuvant radiotherapy and chemotherapy is questionable. This research was designed to find prognostic factors for DDCS and evaluate the impact of adjuvant therapies on localized cases.</p><p><strong>Methods: </strong>One hundred thirty-two patients with DDCS diagnosed by pathology in the period 2006 to 2022 were identified in the Japanese National Bone and Soft Tissue Tumor Registry database and were retrospectively analyzed.</p><p><strong>Results: </strong>Patients with distant metastases at diagnosis (n = 34) had significantly poorer survival than those without metastases (n = 98), with a 5-year disease-specific survival (DSS) of 9.7% vs. 37.1% (P < 0.0001). For patients without distant metastasis at diagnosis, uni- and multivariate analysis showed that R1 or R2 surgical margin was an independent risk factor linked with unfavorable local recurrence (hazard ratio [HR] 3.39 [95% CI: 1.35-8.52]; P = 0.010). Adjuvant radiotherapy was not associated with local recurrence (HR 2.41 [95% CI: 0.87-6.64]; P = 0.090). Larger size (HR 1.13 [95% CI: 1.06-1.19]; P < 0.001) and no surgery (HR 3.87 [95% CI: 1.61-9.28]; P = 0.002) were independent risk factors for unfavorable DSS. Previous surgery (HR 0.19 [95% CI: 0.04-0.84]; P = 0.028) and adjuvant chemotherapy (HR 0.36 [95% CI: 0.16-0.77]; P = 0.009) were independent risk factors for favorable DSS.</p><p><strong>Discussion: </strong>Survival may have been improved by chemotherapy, but the effect of adjuvant radiotherapy in controlling the local spread of the tumor appears to have been limited in DDCS cases that were localized.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"16"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cemented dual mobility cup for primary total hip arthroplasty: survival and quality of life. A multicenter study.","authors":"Jairo Alonso Rincón, Camilo de la Pava, Rubén Velandia, Sofía Muñoz-Medina, Andre Ferreira","doi":"10.1051/sicotj/2025006","DOIUrl":"10.1051/sicotj/2025006","url":null,"abstract":"<p><strong>Introduction: </strong>Dual mobility cups are characterized by having a prosthetic head inside a polyethylene core that later articulates with a metal cup implanted in the acetabulum. These cups can be cemented or uncemented. This study aimed to determine the survival of a cemented dual-mobility cup (CDMC) with a cobalt-chromium head (CoCr) and the quality of life (QOL) of operated patients.</p><p><strong>Methodology: </strong>Multicenter historical cohort study where survival and QOL were estimated. The cohort includes patients who underwent a primary total hip arthroplasty (THA) with a CDMC and CoCr head. The patients were operated on between 2011 and 2013.</p><p><strong>Results: </strong>40 patients from 6 institutions with a median age of 81 (IQR 22.25) years. The results in the Kaplan-Meier estimation showed a survival of 94.2% (95% CI [86.6% - 100%]) at 5 years and a maximum follow-up of 9.5 years. Three failures occurred (two dislocations and one mechanical loosening), and Oxford Hip Scale (OHS) of 41.5 (IQR 10.50) points was recorded.</p><p><strong>Conclusions: </strong>In terms of survival and the score obtained in the OHS, the CDMC has comparable results with the scientific literature found on uncemented dual mobility cups. This demonstrates adequate results in patients with a maximum follow-up of 9.5 years.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"14"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liposomal bupivacaine versus standard periarticular injections in total hip and knee arthroplasty: a prospective, randomized non-inferiority trial.","authors":"Joseph Bowen, Joshua P Rainey, Jonathan Linthicum, Brenna E Blackburn, Lucas A Anderson","doi":"10.1051/sicotj/2025012","DOIUrl":"10.1051/sicotj/2025012","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous multimodal pain protocols have been developed to optimize pain control, reduce narcotics consumption, and shorten the length of stay after total hip and knee arthroplasty (THA/TKA). Liposomal bupivacaine (LB) has been postulated to reduce narcotic requirements after arthroplasty but is not without additional cost. The aim of this study was to determine if the addition of LB to our standard periarticular injection would improve postoperative pain and shorten the length of stay in patients undergoing TKA or THA.</p><p><strong>Methods: </strong>We performed a prospective randomized, blinded non-inferiority study of patients undergoing THA and TKA. Patients were randomized to a periarticular injection with and without LB. There were 118 hips and 64 knees included in the study with no demographic differences between groups. Post-operative pain management was performed by a second provider who was blinded to the patient's experimental group designation.</p><p><strong>Results: </strong>Cost analysis determined that LB increased cost by $305 dollars per patient when accounting for the cost of injections as well as intravenous and oral pain medications. LB led to a minor reduction in narcotic use in THA patients (equivalent to a single 10 mg oxycodone dose), but this difference may lack clinical relevance. No significant benefits were observed in TKA patients. No difference was identified in self-reported pain scores or lengths of hospital stay.</p><p><strong>Discussion: </strong>The addition of LB did not significantly reduce narcotic consumption in patients undergoing TKA, while the cost of LB is prohibitive and should be considered an area of potential cost savings by surgeons and hospitals. The minor reduction in narcotic use in patients undergoing THA likely lacks clinical significance.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"17"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous metallosis following ceramic insert fracture in total hip arthroplasty: a case report and revision with ceramic-on-ceramic bearing couple.","authors":"Vasileios Giovanoulis, Angelo V Vasiliadis, Simon Marmor","doi":"10.1051/sicotj/2025007","DOIUrl":"10.1051/sicotj/2025007","url":null,"abstract":"<p><p>Ceramic fractures in total hip arthroplasty (THA) are rare complications that pose significant challenges for revision surgery. This case report describes a 68-year-old male who experienced a spontaneous alumina (ceramic) insert and head fracture four years after the initial THA. The first revision with cobalt-chrome and polyethylene components led to severe metallosis, including subcutaneous tissue discoloration. A second revision utilized a ceramic-on-ceramic (CoC) bearing couple, resulting in excellent functional outcomes and resolution of symptoms. Cutaneous pigmentation post-THA is rare and has not been previously reported following a ceramic fracture. The case underscores the need for careful material selection in revision surgery to minimize complications such as metallosis. The decision to use a ceramic-on-ceramic bearing couple in this case proved effective, ensuring durability and reducing the risk of third-body wear, which can result from inadequate management of ceramic fractures and lead to joint, systemic, or cutaneous complications.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional alignment is a feasible alignment strategy in robotic assisted total knee arthroplasty for knee osteoarthritis with extra-articular deformity - A case series.","authors":"Wei Cheong Eu, Jade Pei Yuik Ho, G Kunalan","doi":"10.1051/sicotj/2024059","DOIUrl":"10.1051/sicotj/2024059","url":null,"abstract":"<p><strong>Introduction: </strong>Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA). FA technique involves the adjustment of components positioning that least compromise the soft tissue envelope while restoring the limb alignment and joint obliquity to create a balanced knee. The aim is to study the outcome of intra-articular correction by robotic assisted TKA using Functional Alignment (FA) technique.</p><p><strong>Methodology: </strong>This is a single surgeon series of 8 patients with extraarticular deformity who underwent robotic assisted total knee arthroplasty (TKA) with FA technique. Soft tissue release was gradually released and followed by adjustments of implant positioning in order to achieve a balanced medio-lateral gap.</p><p><strong>Results: </strong>Postoperatively, the lower limb alignment of all patients were restored within 6° (mean 4.54°) based on functional alignment boundaries. Knee phenotype and joint line obliquity (JLO) were restored in comparison to contralateral lower limb. There were 6 varus and 2 valgus malalignment. 7 patients were implanted with posterior stabilized implants while 1 was implanted with cruciate retaining implant. Arc of knee flexion and extension improved (P = 0.002). There was a large postoperative improvement in the Knee Society Score (KSS) (P < 0.001).</p><p><strong>Discussion: </strong>Intraarticular correction by TKA for EAD with knee arthritis is technically reliable with robotic technology. It allows intraoperative adjustment following functional alignment philosophy, thereby, restoring pre-arthritic alignment, knee phenotype and joint line obliquity.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"2"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rectus abdominis tendon insertion to the pubic bone and its clinical implications: A cadaveric study.","authors":"Evangelos A Tourvas, Aristidis H Zibis, Michail E Klontzas, Apostolos H Karantanas, Johannes D Bastian, Theodoros H Tosounidis","doi":"10.1051/sicotj/2024053","DOIUrl":"10.1051/sicotj/2024053","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study is to determine the rectus abdominis tendon (RAT) insertional anatomy and consequently clarify the extension of secure mobilization of the tendon from the pubic bone in the setting of anterior approaches in pelvic and acetabular reconstruction surgery.</p><p><strong>Materials and methods: </strong>Eleven fresh frozen cadaveric pelvises were dissected by two fellowship-trained orthopaedic trauma surgeons utilizing the anterior intrapelvic approach (AIP). The RAT at the pubic body was dissected, and its footprint on the pubic bone was defined, marked, and measured.</p><p><strong>Results: </strong>Nineteen (19) RAT insertions were analyzed. The average total medial vertical length was 33 mm (range 26-42 mm), and the average total lateral vertical length was 36.5 mm (range 26-46 mm). The total width of the proximal insertion on both sides was measured at an average of 20.42 mm (range 14-24 mm). The average width of the tendon at the transition area between the cranial and caudal areas of the pubic bone was 16.45 mm (range 12-22 mm). The average distal insertion width of the RAT was less than the proximal and middle widths, measuring 10.45 mm (range 8-13 mm).</p><p><strong>Conclusion: </strong>The tendon can be safely mobilized up to an average total medial vertical length of 33 mm (and in no case more than 42 mm) and to an average total lateral vertical length of 36.5 mm (and in no case more than 46 mm). This piece of anatomical information will equip orthopaedic surgeons with a better understanding of the insertional anatomy of the RAT and subsequent safer surgical release when performing anterior approaches to the pelvic ring.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"10.1051/sicotj/2025002","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":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}