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EFFECT OF BONE TUNNELS POSITIONING ON OUTCOMES OF TRANSTIBIAL ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
- Authors: Bantser S.A.1, Trachuk A.P.1, Bogopol’sky O.E.1, Tikhilov R.M.1,2, Sushkov I.V.1, Murga E.A.1
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Affiliations:
- Vreden Russian Research Institute of Traumatology and Orthopedics
- Mechnikov North-Western State Medical University
- Issue: Vol 23, No 3 (2017)
- Pages: 7-16
- Section: Clinical studies
- URL: https://journal.rniito.org/jour/article/view/769
- DOI: https://doi.org/10.21823/2311-2905-2017-23-3-7-16
- ID: 769
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Abstract
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.
About the authors
S. A. Bantser
Vreden Russian Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: sergeibantser@gmail.com
Банцер Сергей Александрович — аспирант
Ул. Акад. Байкова, д. 8, Санкт-Петербург, 195427
Russian FederationA. P. 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
Russian FederationO. E. 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
Russian FederationR. M. 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
Russian FederationI. V. 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
Russian FederationE. A. Murga
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Evgeny Ya. Murga — Radiologist
8, ul. Akad. Baykova, St. Petersburg, 195427
Russian FederationReferences
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