Improperly placed anterior cruciate ligament grafts: correlation between radiological parameters and clinical results

Sommer, Christian; Friederich, Niklaus F.; Müller, W

doi:10.1007/s001670000125

Cited by 216 publications

(167 citation statements)

References 18 publications

(31 reference statements)

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have used radiographic techniques to reference the location of the ACL [7,21,46]. In the current study, we found the ACL attachment site was centered near the intersection of an anteroposterior line passing through the most posterior point on the cartilage-bone border and a proximodistal line passing the most proximal corner of the cartilage visible in the notch (Fig.…”

Section: Discussionsupporting

confidence: 53%

“…Inaccurate femoral tunnel placement is a common cause of failure in ACL reconstruction [3,18,19,21,25,29,46] with the graft often being placed too far anteriorly. An anteriorly oriented graft does not restore the oblique orientation of the ACL and has limited ability to restore normal knee stability [30,44].…”

Section: Discussionmentioning

confidence: 99%

“…Many authors believe improper femoral tunnel placement is a common reason for failure of an ACL reconstruction [3,19,21,25,29,37,46,54]. Frequently, the grafts are placed too far anteriorly on the femur, resulting in a vertically oriented graft [5,9,16,25,29,56].…”

Section: Introductionmentioning

confidence: 99%

“…The transtibial technique, in which the femoral tunnel is drilled through the tibial tunnel, is commonly used in ACL reconstruction [5,19,29,46]. However, several studies have suggested that the transtibial technique might not be able to center the graft near the anatomic center of the ACL, owing to constraints imposed by the tibial tunnel [5,9,29].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

138

143

View full text Add to dashboard Cite

Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 ± 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 ± 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

show abstract

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

138

143

View full text Add to dashboard Cite

show abstract

“…ACL reconstruction is one of the most common orthopaedic procedures in North America [18], and multiple studies have demonstrated that correct tunnel placement is a key factor for a successful clinical outcome [19][20][21][22]. Considerable variation in tunnel placement has been reported with conventional techniques [23,24], and up to 80 % of complications are related to malpositioned tunnels [25].…”

Section: Anterior Cruciate Ligament Reconstructionmentioning

confidence: 99%

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

Young

Safran

Clatworthy³

2013

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Computer-assisted surgery (CAS) has been investigated in a number of sports medicine procedures in the knee. Current barriers to its widespread introduction include increased costs, duration, and invasiveness of surgery. Randomized trials on the use of CAS in anterior cruciate ligament reconstruction have failed to demonstrate a clinical benefit. Data on CAS use in high tibial osteotomy are more promising; however, long-term studies are lacking. CAS has a number of research applications in knee ligament surgery, and studies continue to explore its use in the treatment of osteochondral lesions. This article reviews the applications of CAS in sports medicine knee surgery and summarizes current literature on clinical outcomes.

show abstract

Precision of ACL tunnel placement using traditional and robotic techniques

Burkart

Debski

McMahon

et al. 2001

Comput. Aided Surg.

View full text Add to dashboard Cite

The objective of this study was to examine the precision of ACL tunnel placement using: (1) CASPAR (orto MAQUET GmbH Co. KG)--an active robotic system, and (2) four orthopedic surgeons with various levels of experience (between 100 and 3,500 ACL reconstructions). The robotic system and each surgeon drilled tunnels for ACL reconstruction in 10 plastic knees (total n = 50) that included a reference cube in the medial aspect of the proximal tibia and distal femur. For the robotic system, the placement of each tunnel was planned preoperatively using custom software and CT data for each femur and tibia. The robotic system then drilled the tunnels in the femur and tibia based on the preoperative plan. For the surgeons, tunnel placement was accomplished using their preferred technique, which was based on the one-incision arthroscopic technique. The distribution of intra-articular points on the tibia was contained within a sphere of radius 2.0 mm (robot system), 2.1 mm (Fellow 1), 2.4 mm (Fellow 2), 3.4 mm (Experienced Surgeon 1), or 2.0 mm (Experienced Surgeon 2). On the femur, no significant differences in the distribution of intra-articular points could be demonstrated between the robotic system (2.1 mm), Fellow 1 (4.5 mm), Fellow 2 (4.1 mm), Experienced Surgeon 1 (2.3 mm), and Experienced Surgeon 2 (3.0 mm). The direction of the tunnels drilled in the femur and tibia was different with the robotic and traditional techniques. However, the robotic system had the most consistent tunnel directions, while the surgeons' tunnels were more dispersed. Variation in surgeon precision of tunnel placement for ACL reconstruction is greater on the femur than the tibia, and this can be correlated with experience. Our data also suggest that the robotic system has the same precision as the most experienced surgeons.

show abstract

Improperly placed anterior cruciate ligament grafts: correlation between radiological parameters and clinical results

Cited by 216 publications

References 18 publications

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

Precision of ACL tunnel placement using traditional and robotic techniques

Contact Info

Product

Resources

About