Trans-tibial guide wire placement for femoral tunnel in single bundle anterior cruciate ligament reconstruction

Autor: Ananta Kumar Naik, Gaurav Upadhyay, C S Arya, Rajendera Kumar Arya, Skand Sinha, Vijay Kumar Jain
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Indian Journal of Orthopaedics, Vol 49, Iss 3, Pp 352-356 (2015)
Indian Journal of Orthopaedics
ISSN: 1998-3727
0019-5413
Popis: Background: Femoral tunnel location is of critical importance for successful outcome of ACL reconstruction. The aim was to study the femoral tunnel created by placing free hand guide wire through tibial tunnel, using the toggle of the guide wire in the tibial tunnel to improve femoral tunnel location. Materials and Methods: 30 cases of a single bundle quadrupled hamstring graft anterior cruciate ligament reconstruction by trans-tibial free hand femoral tunnel creation is studied in this prospective study. The side to side play of the guide wire in the tibial tunnel was used to improve the tunnel location on femoral wall. The coronal angle of the femoral tunnel was measured on the anteroposterior radiograph. The femoral tunnel location on the lateral radiograph of the knee was recorded according to Amis method. Lysholm scoring was done preoperative and at each follow up. Assessment of laxity was done by Rolimeter (Aircast™ ) and pivot shift test. Results: The mean coronal angle of the femoral tunnel in postoperative radiograph was 47΀. In lateral radiograph, the femoral tunnel was found to be >60% posterior on Blumensaat line in 67% cases (n = 20) and in the 33% cases (n = 10) it was anterior. The mean Lysholm score improved from 74.6 preoperative to 93.17 postoperative with no objective evidence of laxity. Conclusion: The free hand trans-tibial creation of the femoral tunnel leads to satisfactory coronal obliquity, but it is difficult to recreate anatomic femoral tunnel by this method as the tunnel is consistently anterior in the sagittal plane.
Databáze: OpenAIRE