Acta Chir Orthop Traumatol Cech. 2021; 88(6):428-433 | DOI: 10.55095/achot2021/064

How the Aperture of Femoral Tunnel Affected in ACL Reconstruction Performed with AM Portal Technique?Original papers

H. BOMBACI1,*, F. CETINKAYA2, O. AKINCI3, G. KILICOGLU3
1 Health Sciences University, Haydarpasa Numune Training and Research Hospital, Orthopaedics and Traumatology Department, Tibbiye Cad. Uskudar, Istanbul, Turkey
2 Suruc State Hospital, Sanli Urfa, Turkey
3 Health Sciences University, Haydarpasa Numune Training and Research Hospital, Radiology Department, Tibbiye Cad. Uskudar, Istanbul, Turkey

PURPOSE OF THE STUDY:
The purpose of this study was to evaluate the position of tibial tunnel (TT) and femoral tunnels (FT) performed by using the anteromedial (AM) portal technique and its effect on the aperture of FT.

MATERIAL AND METHODS:
A total 44 patients operated for anterior cruciate ligament (ACL) rupture by AM portal technique between January 2013 and July 2015, were included in this study. They were subjected to a magnetic resonance imaging of the knee to assess the FT, dimensions of the FT aperture and TT. The location of the ACL graft within the joint was compared with the intact ACL of healthy individuals. The patients were also evaluated using Lysholm and IKDC subjective scores for functional outcome.

RESULTS:
The mean FT angle on both the coronal plane (42.88°±5.83°) and the sagittal plane (68.47°±9.57°) was significantly different from the intra-articular part of the hamstring autograft angles (74.93°±7.27° and 58.74°±4.88°, respectively) (p

Keywords: knee, anterior cruciate ligament reconstruction, femoral tunnel, tibial tunnel, anteromedial portal

Published: December 15, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
BOMBACI H, CETINKAYA F, AKINCI O, KILICOGLU G. How the Aperture of Femoral Tunnel Affected in ACL Reconstruction Performed with AM Portal Technique? Acta Chir Orthop Traumatol Cech. 2021;88(6):428-433. doi: 10.55095/achot2021/064. PubMed PMID: 34998446.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Amano H, Tanaka Y, Kita K, Uchida R, Tachibana Y, Yonetani Y, Mae T, Shiozaki Y, Horibe S. Significant anterior enlargement of femoral tunnel aperture after hamstring ACL reconstruction, compared to bone-patellar tendon-bone graft. Knee Surg Sports Traumatol Arthrosc. 2019;27:461-470. Go to original source... Go to PubMed...
    2. Arno S, Bell CP, Alaia MJ, Singh BC, Jazrawi LM, Walker PS, Bansal A, Garofolo G, Sherman OH. Does anteromedial portal drilling improve footprint placement in anterior cruciate ligament reconstruction? Clin Orthop Relat Res. 2016;474:1679-1689. Go to original source... Go to PubMed...
    3. Bedi A, Maak T, Musahl V, Citak M, O'Loghlin PF, Choi D, Pearle AD. Effect of tibial position on stability of the knee after anterior cruciate ligament reconstruction. Is the tibial tunnel position most important? Am J Sports Med. 2011;39:366-373. Go to original source... Go to PubMed...
    4. Bedi A, Musahl V, Steuber V, Kendoff D, Choi D, Allen AA, Pearle AD, Altchek DW. Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy. 2011;27:380-390. Go to original source... Go to PubMed...
    5. Celik H, Lee D. Comparison of the aperture and midportion femoral tunnel widening after anterior cruciate ligament reconstruction. A systemic review and meta-analyses. Medicine (Baltimore). 2019;98:e16121. Go to original source... Go to PubMed...
    6. Chalmers PN, Mall NA, Cole BJ, Verma NN, Bush-Joseph CA, Bach BR Jr. Anteromedial versus transtibial tunnel drilling in anterior cruciate ligament reconstructions: A systematic review. Arthroscopy. 2013;29;1235-1242. Go to original source... Go to PubMed...
    7. Chang CB, Choi J-Y, Koh IJ, Lee KJ, Lee K-H, Kim TK. Comparisons of femoral tunnel position and length cruciate ligament reconstruction: Modified transtibial versus anteromedial portal technique. Arthroscopy. 2011;27:1389-1394. Go to original source... Go to PubMed...
    8. Chen Y, Chua HZ, Singh A, Tan JH, Tan SH, Tai BC, Lingaraj K. Outcome of single-bundle hamstring anterior cruciate ligament reconstruction using the anteromedial versus the transtibial technique: A systematic review and meta-analysis. Arthroscopy. 2015;31:1784-1794. Go to original source... Go to PubMed...
    9. Greis PE, Burks RT, Bachus K, Luker MG. The influence of tendon length and fit on the strength of a tendon-bone tunnel complex. A biomechanical and histologic study in the dog. Am J Sports Med. 2001;29;493-497. Go to original source... Go to PubMed...
    10. Hamilton SC, Jackson ER, Karas SG. Anterior cruciate ligament femoral tunnel drilling through anteromedial portal: axial plane drill angle affects tunnel length. Arthroscopy. 2011;27:522-525. Go to original source... Go to PubMed...
    11. Ilingrowth KD, Hensler D, Working ZM, Macalena JA, Tashman S, Fu FH. A simple evaluation of anterior cruciate ligament femoral tunnel position: The inclination angle and femoral tunnel angle. Am J Sports Med. 2011;39:2611-2618. Go to original source... Go to PubMed...
    12. Kim JG, Chang MH, Lim HC, Bae JH, Lee SY, Ahn JH, Wang JH. An in vivo 3D computed tomographic analysis of femoral tunnel geometry and aperture morphology between rigid and flexible systems in double-bundle anterior cruciate ligament reconstruction using the transportal technique. Arthroscopy. 2015;31:1318-1329. Go to original source... Go to PubMed...
    13. Lee D-H, Kim H-J, Ahn H-S, Bin S-I. Comparison of femur tunnel aperture location in patients undergoing transtibial and anatomical single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2016;24:3713-3721. Go to original source... Go to PubMed...
    14. Lubowitz JH, Konicek J. Anterior cruciate ligament femoral tunnel length: cadavaric analysis comparing anteromedial portal versus outside in technique. Arthroscopy. 2010;26:1357-1362. Go to original source... Go to PubMed...
    15. Mehta A, Lin CC, Campbell RA, Chin G, McGarry MH, Lee TQ, Adamson GJ. Effects of anteromedial portal versus transtibial ACL tunnel preparation on contact characteristics of the greaft and the tibial tunnel aperture. Clin Orthop Surg. 2019;11:52-59. Go to original source... Go to PubMed...
    16. Moon D, Jo H-S, Lee D-Y, Kang D-G, Byun J-H, Hwang S-C. Influence of the different anteromedial portal on femoral tunnel orientation during anatomic ACL reconstruction. Acta Orthop Traumatol Turc. 2017;51:227-232. Go to original source... Go to PubMed...
    17. Musahl V, Plakseychuk A, VanScyoc A, Sasaki T, Debski RE, McMahon PJ, Fu FH. Varying femoral tunnels between the anatomical footprint and isometric positions: effect on kinematics of the anterior cruciate ligament-reconstructed knee. Am J Sports Med. 2005;33:712-718. Go to original source... Go to PubMed...
    18. Nishimoto K, Kuroda R, Mizuno K, Hoshino Y, Nagamune K, Kubo S, Yagi M, Yamaguchi M, Yoshiya S, Kurosaka M. Analysis of the graft bending angle at the femoral tunnel aperture in anatomic double bundle anterior cruciate ligament reconstruction: a comparison of the transtibial and the far anteromedial portal technique. Knee Surg Sports Traumatol Arthrosc. 2009;17:270-276. Go to original source... Go to PubMed...
    19. Segawa H, Koga Y, Omori G, Sakamoto M, Hara T. Influence of femoral tunnel location and angle on contact pressure in the femoral tunnel in anterior cruciate ligament reconstruction. Am J Sports Med. 2003;31;444-448. Go to original source... Go to PubMed...
    20. Shetty SM, Shetty V, Ballal A, Mohanchandran J, Hegde A. A radiological comparative study between transtibial & anteromedial portal drilling of femoral tunnel in single bundle anterior cruciate ligament reconstruction: a comparison of four angles. Arthroscopy. 2016;3:22-27. Go to original source...
    21. Sim JA, Gadikota HR, Li J-S, Li G, Gill TJ. Biomechanical evaluation of knee joint laxities and graft forces after anterior cruciate ligament reconstruction by anteromedial portal, outside-in, and transtibial techniques. Am J Sports Med. 2011;39:2604-2610. Go to original source... Go to PubMed...
    22. Tachibana Y, Mae T, Shino K, Ohori T, Amano H, Yoshikawa H, Nakata K. Femoral tunnel enlargement after anatomic anterior cruciate ligament reconstruction: bone-patellar tendon-bone /single rectangular tunnel versus hamstring tendon /double tunnels. J Orthop Sci. 2018;23:1011-1018. Go to original source... Go to PubMed...
    23. Xu Y, Ao Y, Wang J, Yu J, Cui G. Relation of tunnel enlargement and tunnel placement after single-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2011;27:923-932. Go to original source... Go to PubMed...

    Return to the content