Abstract
Graft tunnel placement is the factor with most influence on the outcome of double-bundle anterior cruciate ligament (ACL) reconstruction. However the final decision for the graft location has to be decided subjectively under arthroscopy, and can be misplaced due to the effect of the knee flexion angle. The displacement of the estimated placement by surgeons from the ACL anatomical attachment is due to the knee's differing knee flexion angle. Eight cadaveric knees and an electromagnetic position recording system were employed. After digitizing the anatomical location of AM and PL bundle center, four experienced surgeons estimated the graft placement repeatedly at 70 degrees , 90 degrees and 110 degrees of knee flexion. The displacements between these two positions were calculated and analyzed separately in antero-posterior and disto-proximal directions. The displacements of the estimated AM bundle placements were 4.7 +/- 3.4 mm at 70 degrees , 4.3 +/- 2.2 mm at 90 degrees , and 6.0 +/- 2.6 mm at 110 degrees , while those of the PL bundle were 4.0 +/- 2.2 mm at 70 degrees , 3.4 +/- 1.9 mm at 90 degrees , and 4.2 +/- 2.5 mm at 110 degrees . The best results were obtained at 90 degrees of knee flexion. Additionally, the estimated placements for both AM and PL bundle were located more distally as the flexion angle increased. Our results imply that the knee should be set at 90 degrees when determining the graft placement in double-bundle reconstruction to prevent misplacement of the graft usually in a disto-proximal direction.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.