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KMID : 1037920140010010023
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Arthroscopy and Orthopedic Sports Medicine
2014 Volume.1 No. 1 p.23 ~ p.30
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Three-dimensional computed tomography evaluation after single-bundle anterior cruciate ligament reconstruction: comparison of the position of femoral tunnel between modified transtibial and outside-in techniques
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Lee Dhong-Won
Lee Sung-Rak
Kim Sang-Bum
Ha Jeong-Ku
Kim Jin-Goo
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Abstract
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Background: The purpose of this study was to compare the femoral tunnel position by three-dimensional computed tomography (3D-CT) after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction was performed using either a modified transtibial technique or outside-in technique.
Methods: We evaluated 98 patients (group 1) who underwent the modified transtibial technique from December 2010 to October 2011, and 51 patients (group 2) who underwent the outside-in technique from May 2012 to March 2013. We retrospectively investigated the femoral tunnel position by taking postoperative 3D-CT scans. The femoral tunnel length was measured during surgery using a depth gauge.
Results: When 3D-CT results were analyzed using the quadrant method, the mean t-value was 32.94% ± 5.16% and 33.27% ± 5.58% for groups 1 and 2, respectively (P = 0.717). Whereas, the mean h-value was 41.89% ± 5.58% and 42.32% ± 9.02% for groups 1 and 2, respectively (P = 0.725). A statistically significant difference was not seen between the two groups for either value. The femoral tunnel length was 36.77 ± 3.69 mm and 34.15 ± 3.16 mm for groups 1 and 2, respectively, and the tunnel length was found to be significantly longer for the modified transtibial group (P < 0.001).
Conclusion: Our modified transtibial technique can be used to make an anatomical femoral tunnel during single-bundle ACL reconstruction to a similar degree as the outside-in technique. Thus, our technique is recommendable to use for the anatomical ACL reconstruction.
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KEYWORD
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Anterior cruciate ligament, Anatomic femoral tunnel, Reconstruction, Transtibial technique, Outside-in technique
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