CORRELATION BETWEEN TUNNEL POSITION ACCORDING TO RADIOLOGICAL DATA AFTER ACL RECONSTRUCTION, SURGEON’S TUNNEL ESTIMATION DURING SURGERY AND ANTROPOMETRIC CHARACTERISTICS OF THE PATIENT

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Abstract

Purpose - to assess the correlation between tunnel position according to radiological data after ACL reconstruction and surgeon’s estimation during surgery. Material and methods. The study included 86 patients who underwent primary ACL reconstruction with the same surgeon and surgical technique in European Clinic of Sports Traumatology and Orthopedics between 2013 and 2015. In all cases hamstring autograft was used and patients received coronal and sagittal radiographs on the first day after surgery. Surgical data on tunnel position were obtained directly from the OR as dictated by the performing surgeon and fixed in the special registry. Radiological data were exported to eFilm, Merge Healthcare software for graphical analysis. Results. The study group included 54 male and 32 female patients, mean age 35.2 ±1,13, range from 17 to 56 years. Analysis of surgical data showed the median femoral tunnel angle on coronal plane to be 45° (IQR 45° - 60°), angle which occurred most often was 45°, median tibial tunnel angle on coronal plane appeared to be 30° (IQR 30° -35°), angle which occurred most often was 30°. According to radiological coronal plane data median femoral tunnel angle accounted 32° (IQR 28° -36°), angle which occurred most often was 35°, while median tibial tunnel angle accounted 20° (IQR 17-25°,) angle which occurred most often was 19°. Coronal plane mean tibial plateau width was 90,2±,1,1mm with tibial tunnel center located on the 48.55% from the medial side. Sagittal plane mean tibial plateau depth was 53,8 ± 0,6 mm with tibial tunnel center located on the 43.95% from the ventral side. Median tibial plateau posterior slope on the sagittal plane accounted 8° (IQR 6°-9°). Conclusion. Tunnel placement during arthroscopic ACL reconstruction could hardly be standardized. Anthropometric differences between patients can lead to different bone tunnel positions even if the procedure is performed by the same surgeon and surgical technique.

About the authors

A. V. Korolev

ECSTO, European Clinic of Sports Traumatology and Orthopaedics , Peoples Friendship University of Russia

Email: fake@neicon.ru
professor of department of traumatology and orthopaedics Russian Federation

N. E. Magnitskaya

ECSTO, European Clinic of Sports Traumatology and Orthopaedics , Peoples Friendship University of Russia

Author for correspondence.
Email: magnitskaya.nina@gmail.com
postgraduate student, department of traumatology, orthopaedics Russian Federation

M. S. Ryazantsev

ECSTO, European Clinic of Sports Traumatology and Orthopaedics , Peoples Friendship University of Russia

Email: fake@neicon.ru
postgraduate student, department of traumatology, orthopaedics and arthrology Russian Federation

Z. Y. Pilipson

Moscow State University of Medicine and Stomatology

Email: fake@neicon.ru
sixth-year student Russian Federation

M. M. Khashanshin

ECSTO, European Clinic of Sports Traumatology and Orthopaedics

Email: fake@neicon.ru
orthopaedics trauma surgeon Russian Federation

D. O. Il’yin

ECSTO, European Clinic of Sports Traumatology and Orthopaedics

Email: fake@neicon.ru
orthopaedics trauma surgeon Russian Federation

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