PURPOSE: the aim of this study was to compare clinical results and location of the femoral tunnel with transtibial (TT) and outside-in (OI) techniques in anterior cruciate ligament (ACL) reconstruction using in vivo 3D CT analysis. METHODS: we prospectively followed up 40 ACL reconstructions in which femoral tunnel placement was performed using two different techniques: TT [20] and OI [20]. Clinical evaluation was based on IKDC and KOOS scores and radiographic analysis with specific 3D CT scans. Tunnel coordinates were calculated using the Bernard-Hertel quadrant method to define the insertion point of the ACL. RESULTS: excellent clinical results were achieved in both groups, which showed comparable IKDC and KOOS scores. Two failures were recorded, both in the TT group. In the high-to-low direction, the position of the femoral tunnel, as measured using the quadrant method, was too high in the TT group, compared to what was observed in the OI group: 10.5 ± 6.9% (0-29%) and 30.2 ± 5.4% (19-42%), (p=0.043). CONCLUSIONS: we found that with the TT technique, compared with the OI technique, the femoral tunnel was located higher in the high-to-low direction and was in a slightly shallower position in the deep-to-shallow direction. Using the OI technique the femoral tunnel was in a position closer to the anatomical ACL footprint than with the TT technique. A femoral tunnel position far from the anatomical footprint of the native ACL would result in a higher failure rate. LEVEL OF EVIDENCE: level II, prospective comparative study.
PURPOSE: the aim of this study was to compare clinical results and location of the femoral tunnel with transtibial (TT) and outside-in (OI) techniques in anterior cruciate ligament (ACL) reconstruction using in vivo 3D CT analysis. METHODS: we prospectively followed up 40 ACL reconstructions in which femoral tunnel placement was performed using two different techniques: TT [20] and OI [20]. Clinical evaluation was based on IKDC and KOOS scores and radiographic analysis with specific 3D CT scans. Tunnel coordinates were calculated using the Bernard-Hertel quadrant method to define the insertion point of the ACL. RESULTS: excellent clinical results were achieved in both groups, which showed comparable IKDC and KOOS scores. Two failures were recorded, both in the TT group. In the high-to-low direction, the position of the femoral tunnel, as measured using the quadrant method, was too high in the TT group, compared to what was observed in the OI group: 10.5 ± 6.9% (0-29%) and 30.2 ± 5.4% (19-42%), (p=0.043). CONCLUSIONS: we found that with the TT technique, compared with the OI technique, the femoral tunnel was located higher in the high-to-low direction and was in a slightly shallower position in the deep-to-shallow direction. Using the OI technique the femoral tunnel was in a position closer to the anatomical ACL footprint than with the TT technique. A femoral tunnel position far from the anatomical footprint of the native ACL would result in a higher failure rate. LEVEL OF EVIDENCE: level II, prospective comparative study.
Authors: Connor G Ziegler; Sean D Pietrini; Benjamin D Westerhaus; Colin J Anderson; Coen A Wijdicks; Steinar Johansen; Lars Engebretsen; Robert F LaPrade Journal: Am J Sports Med Date: 2010-12-20 Impact factor: 6.202
Authors: Patrick Sadoghi; Albert Kröpfl; Volkmar Jansson; Peter E Müller; Matthias F Pietschmann; Martin F Fischmeister Journal: Arthroscopy Date: 2010-12-08 Impact factor: 4.772
Authors: Sebastian Kopf; Brian Forsythe; Andrew K Wong; Scott Tashman; James J Irrgang; Freddie H Fu Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-12-31 Impact factor: 4.342
Authors: Marco Cuzzolin; Davide Previtali; Marco Delcogliano; Giuseppe Filardo; Christian Candrian; Alberto Grassi Journal: Orthop J Sports Med Date: 2021-07-12