Aperture Position Research Articles

The effects of aperture position and length in side-vented needles on root canal irrigation: A computational fluid dynamics study

IntroductionRoot canal irrigation is crucial for infection control during root canal treatment. Side-vented needles for positive pressure irrigation are commonly used in clinical practice. However, variations in needle design among manufacturers can impact the fluid dynamics of irrigation. This study aims to use computational fluid dynamics to explore the flow characteristics of different needle aperture lengths and positions, and their effects on the effectiveness and safety of irrigation, using a validated passive scalar transport numerical model. MethodsThe validation of the CFD irrigant model was achieved by comparing it with an in vitro irrigation experiment model. The CFD model used scalar concentration, while the in vitro experiment model used red dye tracing. Using a standard 30G side-vented needle as a reference, virtual needle models featuring four aperture lengths and three positions were created. These virtual irrigation needles were then placed in two root canal geometries for CFD simulation to evaluate fluid exchange capabilities and related fluid dynamic parameters. ResultsThe results of the CFD simulation, using a scalar transport model, closely matched the in vitro tracer tests for irrigation experiments across seven root canal geometries. The CFD analysis indicated that positioning the aperture lower increased the irrigant exchange distance. Notably, decreasing the aperture length to 0.25x, and positioning it at the lower end of the needle significantly increased exchange distance and shear stress, while reducing apical pressure. ConclusionsThese results indicate that the position and length of the aperture affect the exchange distance of irrigant flow, wall shear stress, and apical pressure. The CFD validation model for scalar transport, based on a steady state, can function as a valuable tool for optimizing the side-vented needle in research. Further research on the design of side-vented needles will enhance the understanding of flow characteristics beneficial for irrigation efficiency in clinical practice.

Unloading Technology and Application Research of Variable Diameter Drilling in Dynamic Pressure Roadway

Theoretical analysis and numerical simulation are used to study the influence of different parameters of variable diameter borehole pressure relief technology on the surrounding rock and support. A strain-softening model was established to analyze the intrinsic connection between the parameters of variable diameter boreholes and the evolution of surrounding rock stress, deformation law, and support strength. The results show that: (1) With the increase in shallow borehole diameter, it is easy to cause anchor de-anchoring phenomenon. (2) After the deep borehole diameter is more than 250 mm, it transfers the peak of the shallow vertical stress to the deep surrounding rock (about 16 m away from the coal wall). (3) If the position of the variable borehole aperture is set between the anchorage zone and the stress peak of the roadway, the stress transfer effect is better, and the influence and effective binding force on the surrounding rock is smaller. (4) When the spacing is 1.0 m~2.0 m, the vertical stress starts to transfer to the deep surrounding rock, the deformation of the surrounding rock is smaller, and the reduction in the effective binding force of the anchors is smaller. The result can provide a reference for similar production conditions.

Improving Second Language Vowel Production With Hand Gestures Encoding Visible Articulation: Evidence From Picture‐Naming and Paragraph‐Reading Tasks

AbstractThis study investigates whether audiovisual phonetic training with hand gestures encoding visible or nonvisible articulation features has a differential impact on learning second language sounds. Ninety‐nine Catalan–Spanish bilingual students were trained to differentiate English /æ/ and /ʌ/, which differ in the visible lip aperture and nonvisible tongue position, with training involving no gestures, gestures representing the lip aperture, or gestures representing the tongue position. Before, immediately after, and 1 week after the training, participants’ perception of the targets was assessed through a word‐identification task, and their production was tested through paragraph‐reading, picture‐naming, and word‐imitation tasks. Although all participants improved in perception and production, the lip hand gesture was more effective in adjusting lip aperture than the other two conditions in the paragraph‐reading and picture‐naming tasks. These results suggest that hand gestures encoding visible rather than nonvisible articulation features are more effective for improving second language pronunciation.

Resolvability of Multiple Microseismic P-Wave Source Regions with Two Large Seismic Arrays in China and the United States

Abstract P-wave microseisms are useful for understanding ocean waves. Resolving and locating multiple P-wave source regions using seismic data can provide valuable information about ocean waves. The resolvability of multiple microseismic P-wave source regions depends on the location accuracy and resolution, which can be improved using multiple large seismic arrays. In this article, we investigate the source locations of P-wave microseisms at the period of 5–10 s by combining the backprojection results from two large dense seismic arrays located in China (ChinArray) and the United States (USArray). We independently process data recorded by ChinArray and USArray during a two-year period (2014–2015) that border both the North Pacific and North Atlantic. Then the results are normalized and summed or intersected in the source region to improve the accuracy of the P-wave microseism source locations by reducing the deviation from the velocity structure model and the array response function. The results show that we can resolve two to three sources with a scale of ∼500–1000 km within one large P-wave source region. We also investigate how array parameters such as aperture, interstation spacing, and geographic position affect the detectability and accuracy of the P-wave microseism sources. The discrepancy in P-wave microseism source locations between backprojection observation and ocean model predictions in source number, source scale, and source region scope imply that the ocean model needs to be improved.

Sub-micron Assembly Alignment Detection Method and System Based on Optical Diffraction

With the continuous development of manufacturing technology, precision instruments are increasingly moving towards miniaturization, precision, and integration. The assembly accuracy of the product has become a critical factor that limits the performance of the product. Assembly alignment is a significant part of the assembly process, and the accuracy of alignment detection has a significant effect on the final assembly accuracy of the product. Currently, the mainstream technology is to recognize and detect the final image of two parts using microscopic visual inspection technology. However, this method struggles to achieve sub-micron level alignment detection accuracy. In this paper, we presented a sub-micron alignment detection system based on optical diffraction, and the factors influencing the detection accuracy are analysed. Based on this, an experimental assembly alignment detection system was designed based on piezoelectric ceramic drive, laser confocal sensor monitoring feedback, and the mapping relationship between the nanoscale moving position of the diffraction aperture and the diffraction result to achieve sub-micron displacement detection. In addition, experimental tests have been carried out to verify the feasibility of this program. The experimental results indicate that the developed alignment detection method and system can achieve sub-micron alignment detection accuracy, providing a novel device and development concept for high-precision assembly alignment detection.

Studies on High-Resolution Airborne Synthetic Aperture Radar Image Formation with Pseudo-Random Agility of Interpulse Waveform Parameters

By means of alteration of the transmitted linear frequency modulation (LFM) signal waveform parameters, such as pulse width or chirp rate, initial phase, pulse repetition interval (PRI), and chirp rate polarity at every position of synthetic apertures, the pseudo-random agility technology of interpulse waveform parameters in airborne Synthetic Aperture Radar (SAR) actively increases the complexity and uncertainty of radar waveforms. This technology confuses jamming interception receivers, thus improving its anti-interference ability for active coherent jamming, which is one of the main research interests of airborne SAR technology. But the pseudo-random agility technology for interpulse waveform parameters faces certain challenges of large computation and complex system design, which need to be further studied and solved. To address these issues, a processing scheme of high-resolution SAR image formation which is appropriate for agile interpulse waveform parameters is proposed in this paper. This method can deal with multiple agile parameters, not only single ones as in most existing literature. Its computation load is nearly comparable to that of traditional SAR image formation with constant waveform parameters. The high-resolution SAR imaging results obtained by processing SAR raw data with agile interpulse waveform parameters demonstrate the effectiveness of the proposed method. In addition, real SAR images with resolutions of 0.5 m and 0.15 m, which are rarely found in the public literature, are shown under the circumstance of randomly changing the transmitted wideband LFM signal pulse parameters one by one.

Effects of Type II Diabetes on Proprioception during a Reach to Pinch Task

Older adults with type II diabetes (T2D) are at risk of developing nerve disorders that result in functional impairment. Most work in proprioceptive dysfunction in older adults with T2D has focused on functional deficits of the lower limb. The purpose of this study was to examine proprioceptive effects of T2D on the upper limb in older adults. Kinematic performance of a reach-to-pinch action toward a virtual target was assessed in a T2D group (60+ years old with T2D) and a healthy age- and sex-matched control group. Tactile and vibratory thresholds did not differ between T2D and controls. Task accuracy via mean pinch location was significantly worse for persons with T2D (pwT2D) with differences in wrist extension/flexion (ex/fl), wrist abduction/adduction (ab/ad), 1st carpometacarpal (CMC) ab/ad, 2nd metacarpophalangeal (MCP2) ex/fl, MCP2 ab/ad, and digit 1 and hand transport trajectories. Group differences persisted with consideration of body mass index; sex differences in task accuracy emerged. Findings indicate that proprioception of the upper extremity is altered in pwT2D such that they exhibit a unique aperture position and aiming strategy during a reach-to-pinch action. These findings characterize functional sensorimotor impairment of the upper limb in pwT2D with respect to workspaces without visual or tactile feedback.

Experimental comparison of linear regression and LSTM motion prediction models for MLC-tracking on an MRI-linac.

Magnetic resonance imaging (MRI)-guided radiotherapy with multileaf collimator (MLC)-tracking is a promising technique for intra-fractional motion management, achieving high dose conformality without prolonging treatment times. To improve beam-target alignment, the geometric error due to system latency should be reduced by using temporal prediction. To experimentally compare linear regression (LR) and long-short-term memory (LSTM) motion prediction models for MLC-tracking on an MRI-linac using multiple patient-derived traces with different complexities. Experiments were performed on a prototype 1.0T MRI-linac capable of MLC-tracking. A motion phantom was programmed to move a target in superior-inferior (SI) direction according to eight lung cancer patient respiratory motion traces. Target centroid positions were localized from sagittal 2D cine MRIs acquired at 4Hz using a template matching algorithm. The centroid positions were input to one of four motion prediction models. We used (1) a LSTM network which had been optimized in a previous study on patient data from another cohort (offline LSTM). We also used (2) the same LSTM model as a starting point for continuous re-optimization of its weights during the experiment based on recent motion (offline+online LSTM). Furthermore, we implemented (3) a continuously updated LR model, which was solely based on recent motion (online LR). Finally, we used (4) the last available target centroid without any changes as a baseline (no-predictor). The predictions of the models were used to shift the MLC aperture in real-time. An electronic portal imaging device (EPID) was used to visualize the target and MLC aperture during the experiments. Based on the EPID frames, the root-mean-square error (RMSE) between the target and the MLC aperture positions was used to assess the performance of the different motion predictors. Each combination of motion trace and prediction model was repeated twice to test stability, for a total of 64 experiments. The end-to-end latency of the system was measured to be (389 ± 15)ms and was successfully mitigated by both LR and LSTM models. The offline+online LSTM was found to outperform the other models for all investigated motion traces. It obtained a median RMSE over all traces of (2.8 ± 1.3)mm, compared to the (3.2 ± 1.9)mm of the offline LSTM, the (3.3 ± 1.4)mm of the online LR and the (4.4 ± 2.4)mm when using the no-predictor. According to statistical tests, differences were significant (p-value <0.05) among all models in a pair-wise comparison, but for the offline LSTM and online LR pair. The offline+online LSTM was found to be more reproducible than the offline LSTM and the online LR with a maximum deviation in RMSE between two measurements of 10%. This study represents the first experimental comparison of different prediction models for MRI-guided MLC-tracking using several patient-derived respiratory motion traces. We have shown that among the investigated models, continuously re-optimized LSTM networks are the most promising to account for the end-to-end system latency in MRI-guided radiotherapy withMLC-tracking.

The Potential Ability of Plan Complexity Metrics on the Dose Calculation and Plans Delivery in Intensity Modulated Radiotherapy.

The excessive modulation of treatment plan during radiotherapy (RT) increases the complexity. Evaluation of the multidimensional relationship between program complexity metrics, computation-based patient-specific quality assurance (PSQA), and conventional measurement-based PSQA could assist in enhancing the robustness of treatment planning, guide the allocation of clinical QA resources, and ultimately lessen QA workload. The fifty-five metrics affecting RT planning and delivery accuracy were calculated by a house-built program to describe the complexity of 404 dynamic IMRT plans, with sensitivity to the small field, aperture position, MLC edge, low MUs, MLC leaf motion, leaf speed/acceleration, etc. The calculation-based PSQA was performed using Monte Carlo (MC) method and Collapsed Cone Convolution (CCC) algorithm, implemented in SciMoCa and Mobius 3D, respectively. The measurement-based PSQA was performed using 3D diode arrays with different geometries covering "O", "+" and " × " shapes which exist in ArcCheck, Delta4 phantom+ (Delta4) and Delta4PT phantom (Delta4PT), respectively. Gamma passing rates (GPRs) were recorded to measure the results of each QA system. This multidimensional relationship was evaluated using correlation analysis and principal component linear regression (PCR) analysis. A total of 4448 GPRs for various QA systems corresponding to two Linacs were counted. The modulation index for speed (MIs) and modulation index for acceleration (MIa) were consistently located at the high points of the radarplots of the Spearman correlation coefficient |rs| between metrics and GPRs of the four QA systems, just except Delta4. Besides, the rs between SciMoCa and ArcCheck were 0.275-0.531 (P ≤ 0.001), SciMoCa and Delta4 were 0.32-0.418 (P ≤ 0.001), and Mobius 3Dand Delta4PT were 0.124-0.226 (P ≤ 0.05). The PCR model's coefficients determination (R2) for SciMoCa were 0.461-0.756 (P ≤ 0.001), ArcCheck were 0.243-0.440 (P ≤ 0.001), Delta4 were 0.268-0.402 (P ≤ 0.001), Mobius 3D were 0.299-0.407 (P ≤ 0.001), and Delta4PT were 0.087-0.141 (P ≤ 0.05). This study is the first overall assessment of the impact of various complexity metrics on the accuracy of TPS calculation and Linac delivery. Of the metrics studied, MIs and MIa metrics have a standout impact on the ability of the TPS calculation and delivery system, extra attention should be paid during the planning process. It is inappropriate to utilize calculation-based QA to predict the results of measurement-based QA since there is a poor correlation between the two. Furthermore, calculation-based QA outperforms measurement-based QA in identifying highly complex plans, which can further guide clinical QA process optimization and save limited clinical resources.

Electrowetting liquid lens integrating adaptive liquid iris

Multifunctional integration is the development direction of electrowetting liquid lenses. We propose an electrowetting liquid lens integrating adaptive liquid iris (ELL-LI) with adjustable radial aperture and axial position. The liquid iris and the liquid lens are both driven by electrowetting on dielectric and integrated in the same chamber together, and share the same conductive liquid part. The liquid iris does not need the flat support of a traditional liquid iris. The aperture can change from 1.16 to 5.11 mm. The iris can move up and down in the axial direction, according to different working electrodes on the side wall. Experiments show that our proposed ELL-LI has the functions of depth of field expansion and field adjustment, which has a great application prospect in imaging systems, such as camera imaging systems, etc.

Automated defect recognition (ADR) for monitoring industrial components using neural networks with phased array ultrasonic images

In this paper, we propose a framework to automate the process of defect characterizing for industrial structural component health monitoring by implementing automatic defect recognition (ADR) system. The ADR system consists of a convolutional neural network (CNN) and an edge detection algorithm medial axis transform (MAT). The CNN learns the defect feature space from the training dataset to detect and classify the defect. The MAT algorithm is used upon post-validation of the ADR, and the predicted feature’s edges are extracted to size them. The ADR is trained using the simulation-assisted finite element (FE) simulation datasets consisting of side drilled holes (SDH) and crack defects images. The training datasets are generated by introducing virtual array source aperture (VASA), which is a full matrix capture (FMC) scanning strategy by activating the group of elements in an active aperture with predefined focal laws to form a focused beam at a virtual source in the material. The VASA technique uses multiple virtual sources and active aperture positions in a given transducer, which are determined using the Poisson point process. The ultrasound beam is excited in sequence on each virtual source, and the reflected wave is recoded using all the transducers in the array to create FMC A-scans signals. The total focusing method (TFM) technique is a postprocessing algorithm implemented on the FMC signal to generate an image. A large quantity of training datasets is created for each defect by modeling various FE models with varying defect morphology. To create nearly close to experimental images, the experimental noise is introduced in the simulated images. The three separate ADR systems are trained with individual defects class and combined defects. The effectiveness of the trained ADR system is validated by conducting experiments on the plates with laboratory-made SDH and crack defects, the casting components, and weldments with unknown defect types and sizes. The mAP of ADR training is 82%, and the F1-score on testing image classification is 89%. The ADR system could detect and size the smallest defect is 0.219 mm, which is λ L /5.

An investigation on electromagnetic shielding effectiveness of metallic enclosure depending on aperture position

Electromagnetic compatibility (EMC) become one of the most important topics during electric vehicle design due to incorporating high voltage systems into conventional vehicle electronic architecture. Electromagnetic shielding enclosure is a conductive barrier utilized for protecting electronic circuits against external electromagnetic interference (EMI). Shielding effectiveness (SE) is a measure of shielding performance for the enclosures. Aperture of the enclosures attenuate SE by permitting EMI leakage to affect the electronic circuits. In this study, the effect of aperture position on SE is investigated while the dimensions of the enclosure remain fixed. It is obtained that SE varies depending on the aperture positions and it gets better while aperture is closer to the corners of the front panel. Then, the effects of different observation points, the dimensions of enclosure and aperture on SE are analysed while keeping the aperture position at the corner. It is obtained that SE gets better when the observation point is located far away from the aperture. Enlarging the enclosure dimensions makes SE better while increasing aperture dimensions attenuates SE. Finally, it is concluded that it is crucial to consider aperture position, observation point, the dimensions of enclosure and aperture to obtain better SE.

Convergent evolution of spherical shells in Miocene planktonic foraminifera documents the parallel emergence of a complex character in response to environmental forcing

AbstractThe spherical encompassing final chamber of the planktonic foraminifera Orbulina universa is a prime example of a complex character whose evolution has been documented by a sequence of intermediate forms. However, the mechanism that induced evolution of the spherical chamber remain unclear. Here we show that shortly after the emergence of Orbulina, documented throughout the oceans, a convergent evolutionary transition occurred in the semi-isolated Paratethys, leading to the emergence of the endemic Velapertina, which occupied a similar niche to Orbulina in the surface waters. Using X-ray computed tomography scanning, we show that the evolution of the encompassing final chamber involved the same sequence of steps in both lineages, combining a progressively spherical shell shape with changes in the position, number, and sizes of apertures. The similarity in the sequence of character acquisitions suggests structural determinism in the way foraminiferal shells are constructed and the presence of natural selection favoring a spherical morphology. Collectively, the emergence of spherical chambers in the two lineages at a similar time suggests that the evolution of this spectacular complex character occurred in response to a singular environmental driver.

Impact of Dimensions, Apertures and Terminals on Stray Inductance of the Laminated Busbar

This paper presents a systematic investigation of the impact of physical parameters such as dimensions, apertures and terminals, on the busbar inductance. A planar laminated busbar with copper conductors and a polyamide insulator is studied using a 3D FEM (Finite Element Modelling) based simulation software. The impact of dimensions such as conductor length, width and thickness, depth of insulator, the effects of aperture number, size, position and connection terminals on the busbar inductance are examined. The magnetic flux density, current density involved and its dependence on the self and mutual inductance of the laminated busbar is analyzed. Laminated busbars provided lower inductance with decreased conductor length, thickness, aperture diameter and depth of insulator. Also, the increased width of the busbar is of the essence for the design of a low inductance busbar. Low inductance laminated busbars are highly beneficial in power converters, powertrain inverters in electric vehicles, photovoltaic converters.

Full-field x-ray fluorescence imaging using a Fresnel zone plate coded aperture

We present an approach to full-field x-ray fluorescence imaging that uses a Fresnel zone plate as a coded aperture positioned between the object and detector. For this particular coded aperture, the incoherent image formation is identical to the coherent propagation image (inline hologram) of an equivalent absorption object. In the first experiment, we show that prior knowledge of the coded aperture structure and position is no longer required. Fast and robust reconstruction algorithms well known from coherent imaging can be applied. We demonstrate the approach using x-ray fluorescence excited by a collimated Cu- K α beam at an ordinary laboratory x-ray source. Images are recorded with a field of view of 1 m m 2 and resolution of 35 µm. The simple and efficient imaging scheme is well suited for further dissemination of x-ray fluorescence imaging and translation to a broader user community, which could take advantage of full-field imaging with chemical contrast. More generally, the scheme also enables full-field imaging of other incoherent radiation processes for which lenses are either not available at all or not with sufficient numerical apertures. Examples include Compton imaging, imaging of inelastic neutron scattering, or γ -ray imaging in nuclear medicine.

Online position correction approach of an industrial robot by using a new photogrammetric measurement system

Six-axis industrial robots are widely used, mainly because of their versatility. However, they have one drawback: they are not as accurate as conventional machine tools. There are currently a number of approaches to increase the accuracy of these robots. This paper reports on the online correction of an ABB IRB 120 industrial robot using a novel photogrammetric measurement device, the Multi Aperture Positioning System (MAPS). As described by Luhmann, multi-camera solutions were previously required for the online measurement of the six degrees of freedom (6DOF = position and orientation in 3D space) of the robot TCP. MAPS offers the advantages of a single-camera system and at the same time the features and accuracy of a multi-camera system. To increase the accuracy of the robot, a correction algorithm is developed. It uses the measured values from MAPS to calculate the deviation of the robot Tool Center Point (TCP) position from the planned position and corrects it online if necessary. In this paper, three experiments are presented and their results discussed. Two to determine the position and trajectory accuracy of the robot and one to determine its z-stability on a trajectory in the xy plane. In each of these experiments, the robot end effector is tracked with the MAPS measurement device. After the actual state of the robot was recorded, all experiments were performed again, this time with the online correction. In all experiments, a significant increase in the accuracy of the robot can be observed. For example, the mean absolute error (MAE) of the position accuracy improved by a factor of 7 from 0.0207 to 0.0029 mm and the path accuracy (MAE) from 0.1140 to 0.0151 mm.

Window geometry and its effect on the experience of illuminated spaces – a study of three daylit architectural cases

Looking at the architecture of modern housing in Denmark, it seems to express an understanding that equals more daylight with good daylight. With coated energy glass, the windows have increased in size, making glass into a façade material. This means that windows are no longer just holes in the façade but rather make up the entire façade itself. This changes the spatial relationship between the window design and distribution of daylight within the interior space, though we seldom address this lacking a vocabulary and methods. This paper sets out to investigate and experiment with how we can describe and document this change in daylight conditions and how these influence our visual environment, using photographs to record this. The methodology focusses on observations of daylit spaces in three different housing examples in Copenhagen from the 1800s to today. By observing the three daylit spaces, it becomes clear that differences in the size, shape, and position of window apertures influence the qualities of light in a space significantly. Considering that when it comes to window apertures different designs affect the experience of light in a space significantly, it is important to take this into account when designing with daylight. It is also important from a sustainability point of view to include this awareness in future design approaches.

The auditory perceived aperture position of the transition between rooms.

This exploratory study investigates the phenomenon of the auditory perceived aperture position (APAP): the point at which one feels they are in the boundary between two adjoined spaces, judged only using auditory senses. The APAP is likely the combined perception of multiple simultaneous auditory cue changes, such as energy, reverberation time, envelopment, decay slope shape, and the direction, amplitude, and colouration of direct and reverberant sound arrivals. A framework for a rendering-free listening test is presented and conducted in situ, avoiding possible inaccuracies from acoustic simulations, impulse response measurements, and auralisation to assess how close the APAP is to the physical aperture position under blindfold conditions, for multiple source positions and two room pairs. Results indicate that the APAP is generally within ± 1 m of the physical aperture position, though reverberation amount, listener orientation, and source position affect precision. Comparison to objective metrics suggests that the APAP generally falls within the period of greatest acoustical change. This study illustrates the non-trivial nature of acoustical room transitions and the detail required for their plausible reproduction in dynamic rendering and game audio engines.

Resolving Space Plasma Species With Electrostatic Analyzers

Electrostatic analyzers resolve the energy-per-charge distributions of charged plasma particles. Some space plasma instruments use electrostatic analyzers among other units, such as aperture deflectors and position sensitive detectors, in order to resolve the three-dimensional energy (velocity) distribution functions of plasma particles. When these instruments do not comprise a mass analyzer unit, different species can be resolved only if there are measurable differences in their energy-per-charge distributions. This study examines the ability of single electrostatic analyzer systems in resolving co-moving plasma species with different mass-per-charge ratios. We consider examples of static plasma consisting of two species of heavy negative ions measured by a typical electrostatic analyzer design, similar to the electron spectrometer on board Cassini spacecraft. We demonstrate an appropriate modeling technique to simulate the basic features of the instrument response in the specific plasma conditions and we quantify its ability to resolve the key species as a function of the spacecraft speed and the plasma temperature. We show that for the parameter range we examine, the mass resolution increases with increasing spacecraft speed and decreasing plasma temperature. We also demonstrate how our model can analyze real measurements and drive future instrument designs.

Posteriorly positioned femoral grafts decrease long-term failure in anterior cruciate ligament reconstruction, femoral and tibial graft positions did not affect long-term reported outcome

PurposeTo investigate the effect that femoral and tibial tunnel positions have on long-term reported and clinical outcome and to identify a safe zone based on favourable outcome.MethodsSeventy-eight patients from a previous randomised controlled trial were included and were followed with a mean follow-up of 11.4 years. All patients had primary trans-tibial anterior cruciate ligament reconstruction performed. The femoral and tibial tunnel positions were visualised and translated in percentages with three-dimensional computed tomography post-operatively. There were 3 separate outcome variables: patient-reported outcome measured with the IKDC Subjective Knee Form, overall failure, and radiographic osteoarthritis. The correlation between tunnel aperture positions and outcome was determined with multivariate regression. The area with best outcome was defined as the safe zone and was determined with Youden’s index in conjunction with receiver operating characteristics.ResultsNo significant relationship was found between tunnel aperture positions and IKDC Subjective Knee Form at 10-year follow-up. The posterior-to-anterior femoral tunnel aperture position parallel to Blumensaat line showed a significant relationship (p = 0.03) to overall failure at 10-year follow-up. The mean posterior-to-anterior tunnel position of the group that did not fail was 37.7% compared to 44.1% in the overall failure group. Femoral tunnel apertures placed further anteriorly had more overall failures at long-term. The cut-off point lies at 35.0% from posterior-to-anterior parallel to Blumensaat. Of the 16 overall failures, 15 (93.8%) were placed further anteriorly than the cut-off point. No significant relationship was found between tunnel aperture positions and radiographic osteoarthritis.ConclusionFemoral and tibial tunnel positions were not associated with long-term patient-reported outcome and radiographic osteoarthritis. Long-term overall failure was more frequently seen in patients with a more anteriorly placed femoral tunnel. This study identified a safe zone located at the most posterior 35% of the femoral condyle parallel to Blumensaat. This knowledge offers guidance to surgeons to operate more precisely and accurately and reconstruct a long-lasting graft.Level of evidenceLevel III.