ISAKOS: 2023 Congress in Boston, MA USA

2023 ISAKOS Biennial Congress ePoster

 

Ideal Combination Of Anatomic Tibial And Femoral Tunnel Positions for Single-Bundle ACL Reconstruction

Kyoung-Ho Yoon, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Cheol Hee Park, MD, PhD, Seoul KOREA, REPUBLIC OF
Sang-Gyun Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Jae-Young Park, MD, Seoul KOREA, REPUBLIC OF
Yoon-Seok Kim, MD, Hongcheon KOREA, REPUBLIC OF
Hee Sung Lee, MD, Seoul KOREA, REPUBLIC OF
Sung Hyun Hwang, MD, Seoul KOREA, REPUBLIC OF
Dae Keun Suh, MD, PhD, Seoul KOREA, REPUBLIC OF
Bo Seung Bae, MD, Seoul KOREA, REPUBLIC OF

Department of Orthopaedic Surgery, Kyung Hee University Hospital , Seoul, Seoul, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

No significant differences in clinical scores, knee joint stability, or graft signal intensity on follow-up MRI were identified between the patients with anteromedially and posterolaterally positioned tunnels.

ePosters will be available shortly before Congress

Abstract

Background

Anatomic anterior cruciate ligament reconstruction (ACLR) is preferred over nonanatomic ACLR. However, there is no consensus on which point the tunnels should be positioned among the broad anatomic footprints.

Purpose/Hypothesis:
To identify the ideal combination of tibial and femoral tunnel positions according to the femoral and tibial footprints of the anteromedial (AM) and posterolateral (PL) anterior cruciate ligament bundles. It was hypothesized that patients with anteromedially positioned tunnels would have better clinical scores, knee joint stability, and graft signal intensity on follow-up magnetic resonance imaging (MRI) than those with posterolaterally positioned tunnels.

Study Design:
Cohort study; Level of evidence, 3.

Methods

A total of 119 patients who underwent isolated single-bundle ACLR with a hamstring autograft from July 2013 to September 2018 were retrospectively investigated. Included were patients with clinical scores and knee joint stability test results at 2-year follow-up and postoperative 3-dimensional computed tomography and 1-year postoperative MRI findings. The cohort was divided into 4 groups, named according to the bundle positions in the tibial and femoral tunnels: AM-AM (n = 33), AM-PL (n = 26), PL-AM (n = 29), and PL-PL (n = 31).

Results

There were no statistically significant differences among the 4 groups in preoperative demographic data or postoperative clinical scores (Lysholm, Tegner, and International Knee Documentation Committee subjective scores); knee joint stability (anterior drawer, Lachman, and pivot-shift tests and Telos stress radiographic measurement of the side-to-side difference in anterior tibial translation); graft signal intensity on follow-up MRI; or graft failure.

Conclusion

No significant differences in clinical scores, knee joint stability, or graft signal intensity on follow-up MRI were identified between the patients with anteromedially and posterolaterally positioned tunnels.