EFFECT OF BONE TUNNELS POSITIONING ON OUTCOMES OF TRANSTIBIAL ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

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Purpose of the study — to evaluate position of bone tunnels after transtibial anterior cruciate ligament reconstruction (ACLR) and to determine the relationship of outcomes on their localization.

Material and methods. 54 patients in follow up from 25 to 57 months after transtibial ACLR with hamstring tendons. In all patients was performed magnetic resonance imaging (MRI) to evaluate structure of graft. Bone tunnels localization was determined by computed tomography with three-dimensional reconstruction. Subjective score evaluation was performing by scales IKDC-2000, KOOS, Lysholm. Knee laxity was measured by anterior drawer, Lachman, pivot-shift tests and with arthrometr. Patient was separated in groups depending on the localization of the femoral tunnel for lateral intercondylar ridge (1 group — center of femoral tunnel in front of the LIR, 2 group — in zone of the LIR).

Results. Tibial tunnel position in both groups of patients was the same and localized in central or back third of the footprint. The center of femoral tunnel in 32 patients (59%) was localized in front of the LIR (1 group), in other 22 (41%) — in proximal part of LIR (2 group). Clinical results show statistically significant differences between groups in knee stability and IKDC-2000. In 1 group 78% patients have knee instability grade 1 or 2, while in 2 group similar symptoms was in 32% patients. IKDC-2000 grade A were attributed 19% patients from 1 group and 64% from 2 group, rest of them was grade B or C.

Conclusions. Transtibial anterior cruciate ligament reconstruction with hamstring tendons in most patients did not allow anatomical femoral tunnel placement. Clinical outcomes were much affected by the localization of bone tunnels.

作者简介

S. Bantser

Vreden Russian Research Institute of Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: sergeibantser@gmail.com

Банцер Сергей Александрович — аспирант 

Ул. Акад. Байкова, д. 8, Санкт-Петербург, 195427

俄罗斯联邦

A. Trachuk

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Alexandr P. Trachuk — Cand. Sci. (Med.) Senior Researcher, the Departament of Sports Traumatology and Rehabilitation 

8, ul. Akad. Baykova, St. Petersburg, 195427

俄罗斯联邦

O. Bogopol’sky

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Oleg E. Bogopol’sky — Orthopedic surgeon matology and Rehabilitation

8, ul. Akad. Baykova, St. Petersburg, 195427

俄罗斯联邦

R. Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics;
Mechnikov North-Western State Medical University

Email: fake@neicon.ru

Rashid M. Tikhilov — Dr. Sci. (Med.) Professor Director of Vreden Russian Research Institute of Traumatology and Orthopedics; Professor of Mechnikov North-Western State Medical University 

8, ul. Akad. Baykova, St. Petersburg, 195427

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I. Sushkov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Ivan V. Sushkov — Head of the Department of X-ray Diagnostics 

8, ul. Akad. Baykova, St. Petersburg, 195427

俄罗斯联邦

E. Murga

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Evgeny Ya. Murga — Radiologist 

8, ul. Akad. Baykova, St. Petersburg, 195427

俄罗斯联邦

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