Anterior versus Posterior Tibial Tunnel Placement in ACL Reconstruction

  • Miller M
  • Laidlaw M
  • Buyukdogan K
N/ACitations
Citations of this article
11Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Objectives: Previously, we reported that the use of the posterior border of the anterior horn of the lateral meniscus as a landmark for tibial tunnel placement during anatomic ACL reconstruction resulted in a wide variation of tunnel location in the sagittal plane. The effects of such tibial tunnel variations on functional outcomes have not been previously reported. Hypothesis: Anteriorly placed tibial tunnels lead to better anterior knee stability than posteriorly placed tunnels. Study Design: Cohort study, Level of evidence 3. Methods: 71 patients (aged 18-55) underwent isolated unilateral anatomic single bundle primary ACL reconstruction with quadrupled hamstring tendons or bone patellar tendon bone autografts between March 2013 and June 2014 by the same surgeon using an accessory medial portal technique. All guide pins for the tibial tunnel were placed using a 55-degree guide using the posterior border of the anterior horn of the lateral meniscus as a landmark. Following pin placement, a true lateral fluoroscopic image was obtained and these were digitally analyzed to measure the location of the pin along the length of the tibial plateau using the method described by Amis and Jakob. The patients were divided into two groups-one anterior and the other posterior to 40% of the tibial plateau length. Side-to-side difference in anterior knee translation (KT-1000), thigh circumference, range of motion, IKDC and Marx activity scale were evaluated and compared between the groups at a minimum of 2 years following ACL reconstructive surgery. Results: 50 patients (26 in the anterior group and 24 in the posterior group) were avaliable for follow-up at a mean of 2.5 years. There was no difference in the terms of age, sex, BMI, loss of extension, graft type (Hams-BPTB) and size (mm) between the groups (p>.05). In terms of stability, the mean side-to-side difference was 0.19±1.3mm for anterior group and 1.27 ±1.3mm for posterior group based on KT-1000 measurements (P

Cite

CITATION STYLE

APA

Miller, M. D., Laidlaw, M. S., & Buyukdogan, K. (2018). Anterior versus Posterior Tibial Tunnel Placement in ACL Reconstruction. Orthopaedic Journal of Sports Medicine, 6(3_suppl), 2325967118S0000. https://doi.org/10.1177/2325967118s00001

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free