Olivier Reynaud1, Cécile Batailler2, Timothy Lording3, Sebastien Lustig1, Elvire Servien1, Philippe Neyret4. 1. Centre Albert Trillat, Hôpital de la Croix Rousse, 103 Grande Rue de La Croix Rousse, 69004, Lyon, France. 2. Centre Albert Trillat, Hôpital de la Croix Rousse, 103 Grande Rue de La Croix Rousse, 69004, Lyon, France. cecile-batailler@hotmail.fr. 3. Melbourne Orthopaedic Group, 33 The Avenue, Windsor, 3181, Australia. 4. Centre Albert Trillat, 69004, Lyon, France.
Abstract
BACKGROUND: One of the principal causes for failure of anterior cruciate ligament reconstruction (ACL) is femoral tunnel mal-position. Several studies compare the position of femoral tunnels achieved with various techniques, with small series and using a quadrant assessment method. QUESTIONS: (1) What is the incidence of anatomical positioning of the intra-articular femoral tunnel aperture in primary ACL reconstruction in a university knee surgery? (2) What are the main errors in positioning? METHODS: 3D-CT scans were performed after primary ACL reconstruction in 135 consecutive cases. The intra-articular position of the femoral tunnel aperture was analyzed using the Magnussen classification. RESULTS: The intra-articular tunnel position was deemed anatomical in 77%, intermediate in 20.8%, and non-anatomical in 2.2%. Among the mal-positioned tunnels, 54.8% were vertical, 29% were anteriorly positioned, and 16.1% were both. CONCLUSIONS: The intra articular femoral tunnel aperture was well positioned using an outside-in technique. The main error of tunnel positioning was a tunnel too vertical. LEVEL OF EVIDENCE: Level III, prospective study (case series).
BACKGROUND: One of the principal causes for failure of anterior cruciate ligament reconstruction (ACL) is femoral tunnel mal-position. Several studies compare the position of femoral tunnels achieved with various techniques, with small series and using a quadrant assessment method. QUESTIONS: (1) What is the incidence of anatomical positioning of the intra-articular femoral tunnel aperture in primary ACL reconstruction in a university knee surgery? (2) What are the main errors in positioning? METHODS: 3D-CT scans were performed after primary ACL reconstruction in 135 consecutive cases. The intra-articular position of the femoral tunnel aperture was analyzed using the Magnussen classification. RESULTS: The intra-articular tunnel position was deemed anatomical in 77%, intermediate in 20.8%, and non-anatomical in 2.2%. Among the mal-positioned tunnels, 54.8% were vertical, 29% were anteriorly positioned, and 16.1% were both. CONCLUSIONS: The intra articular femoral tunnel aperture was well positioned using an outside-in technique. The main error of tunnel positioning was a tunnel too vertical. LEVEL OF EVIDENCE: Level III, prospective study (case series).
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