Femoral Tunnels in Anatomical ACL Reconstruction: Techniques Inside Out X Outside In

Abstract

Objective: To observe the accuracy and the advantages and disadvantages of the femoral tunnels made by the two techniques. Materials and Methods: We randomly summoned nineteen patients undergoing anatomic ACL reconstruction in a single band technique by the same surgeon: Ten by group II (GII) and nine by Group I (GI). GI: drilling in the technical in-out. GII: drilling the technique out-in. The patients underwent a CT scan with three-dimensional reconstruction of the distal femur. Was applied the technique of quadrants described by Bernard and Hertel and optimized for position by Forsythe and observed in the femoral tunnel: the accuracy of the joint entry; posterior cortical thickness in that point; emergency lateral distance to the lateral epicondyle and the overall length. Results: The coordinates of the distances obtained average was very close, with no statistical difference comparable to that obtained by Bernard and Hertel and Forsythe. The distance from the tunnel exit to the lateral epicondyle obtained average 1.46 cm in GI and 0.47 cm in GII, with a significant statistical difference. The thickness of the posterior cortex was 3.9 mm in GI and 5.4 mm in GII, with no statistical difference. The length averaged was 3.07 cm in GI and GII in 2.94 cm, with no statistical difference. Conclusions: Both techniques allow well placed tunnels, with no statistical difference. In the technique in-out the tunnel exit is closer to the lateral epicondyle. The thickness of the posterior cortex is similar. The length of the femoral tunnel is similar and around 3 cm.