Transportal femoral drilling creates more horizontal ACL graft orientation compared to transtibial drilling: A 3D CT imaging study
| Autor: | S. Clockaerts, Kristien Vuylsteke, T Leenders, A. Van Haver, Koen Lagae, Peter Verdonk, J. Verhaegen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Rotation Anterior cruciate ligament Transplantation Autologous 03 medical and health sciences Young Adult 0302 clinical medicine Imaging Three-Dimensional medicine Humans Orthopedics and Sports Medicine Femur Tibia Autografts Orientation Spatial Orthodontics 030222 orthopedics Femoral tunnel Anterior Cruciate Ligament Reconstruction business.industry Orientation (computer vision) Horizontal orientation 030229 sport sciences musculoskeletal system Surgery surgical procedures operative medicine.anatomical_structure Acl graft Female Ct imaging business Tomography X-Ray Computed |
| Zdroj: | The Knee. 23(3) |
| ISSN: | 1873-5800 |
| Popis: | The principle of anatomic anterior cruciate ligament (ACL) reconstruction is to create a femoral and tibial tunnel that resembles the insertion of the native ACL. Anatomic reconstruction leads to a more horizontal graft orientation that provides more rotational stability. The aim of this study is to investigate the best method to achieve anatomical reconstruction of femoral insertion of the ACL and thus, a more horizontal orientation of the ACL. We compared tunnel position and orientation between transportal femoral drilling technique and transtibial technique.Thirty-two patients were included. Post-operative CT scans were obtained and femur, tibia and ACL tunnels were reconstructed. The position and orientation of tibial and femoral tunnels were quantified using the quadrant method, and femoral tunnel length, ellipticity and posterior wall breakage were assessed. We also investigated clinical outcome.Analyses show that transportal drilled femoral tunnels were situated significantly lower than transtibial drilled tunnels (p0.0001), resulting in a significantly more horizontal oriented ACL in the transportal group in coronal (p0.0001) and sagittal plane (p=0.01). No differences were observed in depth of femoral tunnel position (p=0.44). Femoral tunnel length was shorter in the transportal group (p=0.01) with a more ellipsoidal femoral aperture (p=0.01). There were no differences between both groups in tibial position. There were no differences in clinical outcome measure between the transportal and transtibial groups.This study indicates that transportal drilling of the femoral tunnel leads to a more horizontal graft orientation of the ACL, without differences in clinical outcome. |
| Databáze: | OpenAIRE |
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