Location of the Femoral Tunnel Aperture in Single-Bundle Anterior Cruciate Ligament Reconstruction

Abstract

The transtibial technique of anatomic reconstruction resulted in more highly positioned femoral tunnels in the low-to-high direction than did the anteromedial portal and outside-in techniques. However, no significant differences in the femoral tunnel location were observed in the deep-to-shallow direction.

Comparison of femur tunnel aperture location in patients undergoing transtibial and anatomical single-bundle anterior cruciate ligament reconstruction

“…These findings were consistent with previous studies [9,24], which compared femoral tunnel locations following the conventional transtibial and anatomical techniques. In traditional transtibial techniques, the femoral tunnel is predetermined by the position of the tibial tunnel, resulting in a nonanatomical location of the femoral tunnel, higher than would have been obtained compared with the original ACL footprint, leading to nonanatomical vertical ACL grafts [18].…”

Comparison of Femoral Tunnel Length and Obliquity Between Transtibial, Anteromedial Portal, and Outside-In Surgical Techniques in Single-Bundle Anterior Cruciate Ligament Reconstruction: A Meta-analysis

“…Therefore the effects of extra weight observed in 3 studies were assessed independently because those studies belonged to different subgroups (transtibial v AM portal and transtibial v OI). 15,21,22 Quality of Included Studies Only 4 of the 14 studies compared demographic data in the transtibial, AM portal, and OI technique groups, and none showed possible confounding factors. Table 3 summarizes the risk of bias for studies included in this meta-analysis.…”

“…11,12 In contrast, sufficient coronal obliquity was reported to be achieved by modifications of the transtibial technique, including internal rotation of the transtibial guide, use of a more medial tibial tunnel starting point, or rotation of the proximal tibia and varus force to the knee joint when drilling the femoral tunnel. 3,[13][14][15][16] Furthermore, to date, there is no general consensus on whether transtibial or independent ACL reconstruction techniques, including the AM portal and OI techniques, result in superior femoral tunnel or graft obliquities in the sagittal plane.…”

Tibial Tunnel Aperture Location During Single-Bundle Posterior Cruciate Ligament Reconstruction: Comparison of Tibial Guide Positions

“…2,3 Studies of both double-and single-bundle PCL reconstructions have paid greater attention to femoral than to tibial tunnel placement because the former has been reported to be the most important determinant of knee stability in PCL reconstruction. [4][5][6][7] However, proper placement of the tibial tunnel is also important because its location can directly affect the posterior and rotational instability of the knee joint.…”