Drilling the Femoral Tunnel During ACL Reconstruction: Transtibial Versus Anteromedial Portal Techniques

被引:29
|
作者
Tudisco, Cosimo [1 ]
Bisicchia, Salvatore [1 ]
机构
[1] Univ Roma Tor Vergata, Dept Orthopaed Surg, I-00133 Rome, Italy
关键词
ANTERIOR CRUCIATE LIGAMENT; PATELLAR TENDON; ARTHROSCOPIC RECONSTRUCTION; KNEE STABILITY; GRAFT FUNCTION; CORONAL PLANE; IN-VITRO; PLACEMENT; LAXITY; ANGLE;
D O I
10.3928/01477447-20120725-14
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Incorrect bone tunnel position, particularly on the femoral side, is a frequent cause of failed anterior cruciate ligament reconstruction. Several studies have reported that drilling the femoral tunnel through the anteromedial portal allows a more anatomical placement on the lateral femoral condyle and higher knee stability than does transtibial reconstruction. In the current study, the femoral tunnel was drilled with transtibial (n=6) and anteromedial (n=6) portal techniques in 12 cadaveric knees. With appropriate landmarks inserted into bone tunnels, the direction and length of the tunnels were determined on anteroposterior and lateral radiographs. Knee stability was evaluated with a KT1000 arthrometer (MEDmetric Corporation, San Diego, California) and pivot shift test, comparing the pre- and postoperative values of both techniques. Finally, all knees were dissected to enhance vision of the insertion of the reconstructed ligament. The anteromedial portal technique led to better placement of the femoral tunnel in the coronal and sagittal planes, with higher knee stability according to the pivot shift test but not the KT1000 arthrometer. Anatomical and clinical results reported in the literature on transtibial and anteromedial portal techniques are controversial, but most of studies report better results with the anteromedial portal technique, especially regarding rotational stability. The current cadaveric study showed that the anteromedial portal technique provided better tunnel placement on the lateral femoral condyle in the coronal and sagittal planes, with an improvement in the rotational stability of the knee.
引用
收藏
页码:E1166 / E1172
页数:7
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