Comparison of Clinical Outcomes between Different Femoral Tunnel Positions after Anterior Cruciate Ligament Reconstruction Surgery

Abstract

There is no robust consensus on whether the more oblique femoral tunnel position offers better results than standard surgical technique in term of operative outcomes. Thus, it is important to determine the thorough position of the femoral tunnels. This study investigated whether a change in the femoral tunnel position in both axial and coronal planes can significantly alter the postoperative functional and clinical outcomes of the patients. Method: This comparative, retrospective, single-center study was performed on 44 patients who had underwent singlebundle Anterior Cruciate Ligament Reconstruction (ACLR). To evaluate the tunnel position in coronal and axial planes, radiographic assessments were done. Based on radiographic data, the patients were classified into 4 groups. The time interval between surgery and last visit averaged 23.6 ± 2.2 months (18-30 mos.). Lysholm knee score, and Cincinnati score were completed for all of the patients. Furthermore, the Lachman, anterior drawer and pivot-shift tests were performed. Results: Of the 44 patients included in the study, 9 patients (20.4%) were classified as the low-anterior group, 17(38.6%) were classified as the lowposterior group and 18(40.9%) were classified as the high-posterior group. None of the patients were included in high-anterior group. A greater mean Lysholm score (96±3) in low-posterior group was the only significant difference between the three groups. Conclusion: Findings of the current study show that with the low-posterior placement of the femoral tunnel, based on both anteroposterior (AP) and tunnel-view x-rays, the better clinical outcomes can be achieved in short-term than the routine tunnel placements