Radiologic Evaluation of Femoral and Tibial Tunnels Created With the Transtibial Tunnel Technique for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Abstract

The purpose of this study was to clarify femoral and tibial tunnel angles in anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. A prospective study was performed in 50 consecutive patients who underwent anatomic double-bundle ACL reconstruction via hamstring tendon grafts for chronic ACL deficiency in the unilateral knee. For this procedure, 2 hamstring tendon grafts were secured with EndoButtons (Smith & Nephew Endoscopy, Andover, MA) on the femur and with 2 staples on the tibia. Each patient underwent radiologic examination 1 year after surgery. The tibial tunnel angles of the posterolateral bundle averaged 40.7 degrees in the anteroposterior view and 35.4 degrees in the lateral view. The tibial tunnel angles of the anteromedial bundle averaged 15.6 degrees in the anteroposterior view and 41.4 degrees in the lateral view. The femoral tunnel angles of the posterolateral bundle averaged 44.0 degrees in the anteroposterior view and 52.0 degrees in the lateral view. The femoral tunnel angles of the anteromedial bundle averaged 18.0 degrees in the anteroposterior view and 49.8 degrees in the lateral view. The given data will be useful for surgeons to evaluate the tunnel positions and standardization postoperatively in anatomic double-bundle reconstruction. Level II, development of diagnostic criteria on the basis of consecutive patients with universally applied reference gold standard.