Femoral tunnel formation using reference anatomical structures of the femoral intercondylar space during anterior cruciate ligament reconstruction

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Abstract

Purpose: a clinical rationale for using reference structures of the intercondylar space to determine the femoral footprint of the ACL. Material: sixty one patients with ACL deficiency who underwent anatomic anterior cruciate ligament reconstruction using single-bundle «bone-patellar tendon-bone» autograft. Methods: radiography and radiometry, computed tomography, arthroscopy, arthrometry. Results: lateral intercondylar and lateral bifurcate ridges can be verified arthroscopically with a frequency of 94% and 48%. Orientation of the femoral tunnel formed using reference structures is more horizontal in coronal plane and has increased sagittal slope compare with traditional technique. Conclusions: The lateral intercondylar and lateral bifurcate ridges can be used as reference structures for femoral tunnel formation during anatomical anterior cruciate ligament reconstruction.

About the authors

D. A. Malanin

Volgograd State Medical University

Author for correspondence.
Email: malanin67@mail.ru
Russian Federation

I. A. Suchilin

Volgograd State Medical University

Email: omnio@mail.ru
Russian Federation

M. V. Demeschenko

Volgograd State Medical University

Email: maximus275@yandex.ru
Russian Federation

L. L. Tscherezov

Volgograd State Medical University

Email: chrzv@rambler.ru
Russian Federation

References

  1. Лисицын М.П., Лисицына Е.М. Компьютерная навигация при артроскопической пластике передней крестообразной связки коленного сустава. Философия и техника. Эндоскопическая хирургия. 2010;(4):34-47
  2. Сучилин И.А., Маланин Д.А., Краюшкин А.И. Референтные анатомические структуры межмыщелковой ямки бедренной кости при пластике передней крестообразной связки. Травматология и ортопедия России. 2012;(3):67-72
  3. Bernard M., Hertel P., Hornung H. et al. Femoral insertion of the ACL. Radiographic quadrant method. Am. J. Knee Surg. 1997;(10):14-22.
  4. Bedi A., Raphael B., Maderazo A., et al. Transtibial versus anteromedial portal drilling for anterior cruciate ligament reconstruction: a cadaveric study of femoral tunnel length and obliquity. Arthroscopy. 2010;(3):342-350.
  5. Behrend H., Stutz G., Kessler M.A. et al. Tunnel placement in anterior cruciate ligament (ACL) reconstruction: quality control in a teaching hospital. Knee Surg. Sports Traumatol. Arthrosc. 2006;(11):1159-1165.
  6. Branch T.P., Siebold R., Freedberg H.I. et al. Doublebundle ACL reconstruction demonstrated superior clinical stability to single-bundle ACL reconstruction: a matched-pairs analysis of instrumented tests of tibial anterior translation and internal rotation laxity. Knee Surg. Sports Traumatol. Arthrosc. 2011;(19):432-440.
  7. Bunchner M., Schmeer T., Schmitt H. Anterior cruciate ligament reconstruction with quadrupled semitendinosus tendon — minimum 6 year clinical and radiological follow-up. Knee. 2007;(14):321-327.
  8. Colvin A.C., Shen W., Musahl V., Fu F.H. Avoiding pitfalls in anatomic ACL reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 2009;(17):956-963.
  9. Dargel J., Schmidt-Wiethoff R., Fischer S. et al. Femoral bone tunnel placement using the transtibial tunnel or the anteromedial portal in ACL reconstruction: a radiographic evaluation. Knee Surg. Sports Traumatol. Arthrosc. 2009;(3):220-227.
  10. Dayal N., Chang A., Dunlop D. et al. The natural history of anteroposterior laxity and its role in knee osteoarthritis progression. Arthritis Rheum. 2008;(52):2343-2349.
  11. Fu F.H., Jordan S.S. The lateral intercondylar ridge — a key to anatomicanterior cruciate ligament reconstruction. J. Bone Joint Surg. (Am.). 2007;(89):2103-2104.
  12. Illingworth K.D., Hensler D., Working Z.M., et al. A simple evaluation of anterior cruciate ligament femoral tunnel position: the inclination angle and femoral tunnel angle. Am. J. Sports Med. 2011;(12):2611-2618.
  13. Iriuchishima T., Shirakura K., Horaguchi T. et al. Rollback of the femoral condyle in anatomical double-bundle anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 2012;(5):941-946.
  14. Kawakami Y., Hiranaka T., Matsumoto T. et al. The accuracy of bone tunnel position using fluoroscopic-based navigation system in anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 2012;(20):1503-1510.
  15. Pascual-Garrido C., Swanson B.L., Swanson K.E. Transtibial versus low anteromedial portal drilling for anterior cruciate ligament reconstruction: a radiographic study of femoral tunnel position. Knee Surg. Sports Traumatol. Arthrosc. 2013;(4):846-850.
  16. Sajovic M., Vengust V., Komadina R. et al. A prospective, randomized comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: five-year follow-up. Am. J. Sports Med. 2006;(34):1933-1940.
  17. Topliss C., Webb J. An audit of tunnel position in anterior cruciate ligament reconstruction. Knee. 2001;(8):59-63.
  18. van der Hart C., van den Bekerom M., Patt T. The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. J. Orthop. Surg. Res. 2008;(3).
  19. van Eck C.F., Morse K.R., Lesniak B.P. et. al. Does the lateral intercondylar ridge disappear in ACL deficient patients? Knee Surg. Sports Traumatol. Arthrosc. 2010;(18):1184-1188.
  20. Xu Y., Ao Y., Wang J. et al. Relation of tunnel enlargement and tunnel placement after single-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2011;(7):923-932.
  21. Yamazaki J., Muneta T., Koga H. et al. Radiographic description of femoral tunnel placement expressed as intercondylar clock time in double-bundle anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 2011;(19):418-423.
  22. Zaffagnini S., Bignozzi S., Martelli S. et al. New intraoperative protocol for kinematic evaluation of ACL reconstruction: preliminary results. Knee Surg. Sports Traumatol. Arthrosc. 2006;(14):811-816.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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