The Effects of Tunnel Position in Patients Who Underwent the Anterior Cruciate Ligament Reconstruction with Transfix Method on the Clinical and Functional Results

Abstract

Objective:The aim of this study is to analyse the effects of femoral and tibial tunnel localization in the sagittal plane in the patients who underwent the anterior cruciate ligament reconstruction with transfix method in our clinic on the clinical and functional results.Methods:36 patients underwent the anterior cruciate ligament reconstruction performed by different surgeons with the same method between January 2010 and December 2014 in Istanbul Medeniyet University Goztepe Training and Research Hospital Orthopaedics and Traumatology Clinic. Femoral and tibial tunnel localization was conducted on the lateral radiography of the knee of the patients. The clinical evaluations of the patients were carried out with lysholm score, IKDC score, tegner activity score, extensor and flexor measured by CYBEX CSMI dynamometer for muscular strength loss.Results:It was observed that femoral tunnel positions of 47.2% (n=17) of the patients were at the intended location while the ones of 52.8% (n=19) were in anterior. Tibial tunnel positions of 52.8% (n=19) of the patients were at the intended location while the ones of 33.3% (n=12) were in anterior, and the ones of 13.9% (n=5) were in posterior. The postoperative lysholm scores of F (+) T (+) group were significantly higher than F (+) T (-) (p=0.004), F (-) T (+) (p=0.004) and F (-) T (-) (p=0.004) groups. The postoperative IKDC score normality of F (+) T (+) group were significantly higher than F (-) T (+). The postoperative tegner measurements of F (+) T (+) group were significantly higher than F (-) T (+). The measurements of extensor deficit of F (+) T (+) (p=0.022) group and F (+) T (-) (p=0.049) group were significantly lower than F (-) T (-) group. The measurements of flexor deficit of F (+) T (+) group were significantly lower than F (-) T (+) (p=0.011) group and F (-) T (-) (p=0.040) group and F (+) T (-) group of flexor deficit measurements significantly lower than F (-) T (+) group (p=0.028) (p<0.05).Conclusion:Misplacement of femoral and tibial tunnels has negative effects on clinic functional results. While misplacement of tibial tunnel can be tolerated better, the placement of femoral tunnel in anterior cannot be tolerated and has further effects on the results.