Stay Ipsilateral: An Analysis of Tibial Tunnel Distance Between Cruciate Ligament Reconstruction and Posterior Meniscal Root Repair

Abstract

PurposeTo establish mean distance or identify intersection between tibial tunnels for posterior meniscal root repair in the setting of anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) reconstruction.MethodsTwelve cadaver knees and 12 solid foam synthetic tibiae were used. ACL and PCL tunnels were drilled for single-bundle reconstruction, and both medial and lateral posterior root repair tunnels were drilled. Specimens underwent computed tomography scanning and shortest distances between tunnels in all planes were measured by 2 readers. Distances were compared between groups using a t-test.ResultsIn ACL reconstruction, the medial meniscal root tunnel was not significantly closer to the cruciate tunnel when drilled from either medial or lateral side (P = .333). The lateral meniscal root tunnel was significantly closer when drilled from medial compared to lateral side (P < .001). In PCL reconstruction, both medial (P = .037) and lateral (P = .028) meniscal root tunnels were significantly closer to the PCL tunnel when drilled from the contralateral side of the tibia.ConclusionThis study demonstrates that posterior meniscal root repair tunnels are often placed within a few millimeters and can even intersect cruciate ligament reconstruction tunnels in the proximal tibia.Clinical RelevanceThe information in this study may assist surgeons in planning for cruciate ligament reconstruction with concomitant posterior meniscal root repair.