Flat-Tunnel Technique With Independently Tensioned Bundles Better Restores Rotational Stability Than Round-Tunnel Technique in Anatomic Anterior Cruciate Ligament Reconstruction Using Hamstring Graft: A Cadaveric Biomechanical Study

Zhang, Jiahao; Shao, Jiayi; Zhao, Fengyuan; Ren, Shuang; Shi, Weili; Ding, Guocheng; Liu, Ping; Ao, Yingfang

doi:10.1016/j.arthro.2021.05.030

Cited by 3 publications

(3 citation statements)

References 47 publications

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“…Lastly, current literature reports controversial biomechanical results between the flat-tunnel and RT techniques in ACL reconstruction. 4,48 Whether the RRT technique has biomechanical advantages over the RT technique was not confirmed in the current study.…”

Section: Discussionmentioning

confidence: 66%

Better Coverage of the ACL Tibial Footprint and Less Injury to the Anterior Root of the Lateral Meniscus Using a Rounded-Rectangular Tibial Tunnel in ACL Reconstruction: A Cadaveric Study

Shao

Zhang

Ren

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: To better restore the anatomy of the native anterior cruciate ligament (ACL) attachment and fiber arrangement, researchers have developed techniques for changing the shape of the ACL bone tunnel during ACL reconstruction. Purpose: To compare the coverage of the ACL tibial footprint and influence on the anterior root of lateral meniscus (ARLM) between a rounded-rectangular tibial tunnel and a conventional round tibial tunnel for ACL reconstruction. Study Design: Controlled laboratory study. Methods: A total of 16 (8 matched-paired) fresh-frozen human cadaveric knees were distributed randomly into 2 groups: a rounded-rectangular tunnel (RRT) group and a round tunnel (RT) group. One of the knees from each pair was reamed with rounded-rectangular tibial tunnel, whereas the other was reamed with round tibial tunnel. Coverage of the ACL tibial footprint and areas of ARLM attachment before and after reaming were measured using 3-dimensional isotropic magnetic resonance imaging. Results: In the RRT group, the average percentage of ACL tibial footprint covered by the tunnel was 70.8% ± 2.5%, which was significantly higher than that in the RT group (48.2% ± 6.4%) ( P = .012). As for the ARLM attachment area, in the RT group, there was a significant decrease (22.5% ± 5.9%) in ARLM attachment area after tibial tunnel reaming compared with the intact state ( P < .001). Conversely, in the RRT group, the ARLM attachment area was not significantly affected by tibial tunnel reaming. Conclusion: Rounded-rectangular tibial tunnel was able to better cover the native ACL tibial footprint and significantly lower the risk of iatrogenic injury to the ARLM attachment than round tibial tunnel during ACL reconstruction.

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Section: Discussionmentioning

confidence: 66%

Better Coverage of the ACL Tibial Footprint and Less Injury to the Anterior Root of the Lateral Meniscus Using a Rounded-Rectangular Tibial Tunnel in ACL Reconstruction: A Cadaveric Study

Shao

Zhang

Ren

et al. 2022

Orthopaedic Journal of Sports Medicine

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“… 3 , 7 , 12 A cadaveric biomechanical study in 2022 demonstrated that the flat tunnel technique is superior in terms of reproducing innate kinematics and rotational stability during ACL reconstruction as opposed to the round bone tunnel technique. 13 …”

Section: Discussionmentioning

confidence: 99%

Modified Anatomical Anterior Cruciate Ligament Reconstruction with Flat Semitendinosus Graft and C-shaped Tibial Canal

Chamieh,

Mourad,

Piontek

2024

Arthroscopy Techniques

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“…In ACL reconstruction surgery, planning of the bone tunnel is of paramount importance. 22 Moreover, 3D CT reconstruction is more helpful to the surgeon in determining the spatial relationship of the bone tunnel to the joint than single arthroscopic vision. Currently, it is not common to use CT reconstruction image for bone tunnel planning during ACL reconstruction surgery.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and accuracy of orthopaedic surgical robot system for intraoperative navigation to locate bone tunnel in anterior cruciate ligament reconstruction

Ding

Yang

Zhang

et al. 2021

Robotics Computer Surgery

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Background:The combination of navigational system and robotics has the potential to accurately identify and drill bone tunnels in anterior cruciate ligament (ACL) reconstruction. This study explores the feasibility and accuracy of bone tunnel positioning using the TiRobot, an orthopaedic surgical robot. Methods:The experiment was divided into two groups. In group A, the bone tunnels were positioned using the TiRobot surgical robot (n = 8). In group B, handheld locators were used for positioning (n = 8).Results: TiRobot can be used for positioning the ACL bone tunnel. The accuracy of positioning the femoral tunnel in group A and B was 1.00 � 0.20 and 3.10 � 0.59 mm, respectively (t = −9.49, P < 0.001). As for tibial tunnel, the accuracy was 1.02 � 0.20 and 2.64 � 0.14 mm, respectively (t = −18.54, P < 0.001). Conclusions:The bone tunnel drilling precision using TiRobot for ACL reconstruction surgery was more accurate than traditional surgical techniques.

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Flat-Tunnel Technique With Independently Tensioned Bundles Better Restores Rotational Stability Than Round-Tunnel Technique in Anatomic Anterior Cruciate Ligament Reconstruction Using Hamstring Graft: A Cadaveric Biomechanical Study

Cited by 3 publications

References 47 publications

Better Coverage of the ACL Tibial Footprint and Less Injury to the Anterior Root of the Lateral Meniscus Using a Rounded-Rectangular Tibial Tunnel in ACL Reconstruction: A Cadaveric Study

Better Coverage of the ACL Tibial Footprint and Less Injury to the Anterior Root of the Lateral Meniscus Using a Rounded-Rectangular Tibial Tunnel in ACL Reconstruction: A Cadaveric Study

Modified Anatomical Anterior Cruciate Ligament Reconstruction with Flat Semitendinosus Graft and C-shaped Tibial Canal

Feasibility and accuracy of orthopaedic surgical robot system for intraoperative navigation to locate bone tunnel in anterior cruciate ligament reconstruction

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