Furthermore, the rotational freedom of the intra-articular portion of a curved guide can assure a wide variability of tunnel angle orientation Fig. Additional file 1: Movie S1. Intentional rotary movement of intra-articular portion of a curved guide. The rotational freedom of the intra-articular portion of a curved guide can assure a wide variability of tunnel angle orientation.
MOV kb. Our results provide a technical consideration for the acquisition of longer tunnel lengths, combined with the use of commercially available flexible reamer and curved guide systems. This study also indicates that three-dimensional tunnel orientations should be stressed for appropriate femoral tunnel length in anatomic ACL reconstruction. This study has several limitations.
At first, there may be a certain degree of variability in the AM and PL femoral tunnel center locations. However, every efforts were put to standardize the starting position of femoral tunnels according to anatomic landmarks of the lateral femur and the knee flexion angle, described in previous literature from our team [ 15 , 24 ]. And the individual data in the present study has been controlled for patient factors and anatomic variables that may affect tunnel length, and this study was performed using 3D virtual models constructed by applying reverse engineering software with high reliability and accuracy.
Several authors have stressed the limitations of two-dimensional radiographic assessment [ 30 , 31 ]. Khalfayan et al. Sommer et al. Seconds, we are not able to be sure that all femoral tunnels in this study provide the best configuration of tunnels. However, our considerations at femoral tunneling should be common agreements to other surgeons for anatomic ACL reconstruction.
Effect of tibial tunnel position on stability of the knee after anterior cruciate ligament reconstruction: is the tibial tunnel position most important? Am J Sports Med. The effect of tunnel placement on rotational stability after ACL reconstruction: evaluation with use of triaxial accelerometry in a porcine model. Knee Surg Sports Traumatol Arthrosc. Anatomical and nonanatomical double-bundle anterior cruciate ligament reconstruction: importance of femoral tunnel location on knee kinematics.
Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 1: basic science. Reconstruction of the proximal insertion of the anterior cruciate ligament. Studies on the accuracy of a non-instrumental method. Femoral tunnel position in anterior cruciate ligament reconstruction using three techniques. A cadaver study. Single-incision technique misses the anatomical femoral anterior cruciate ligament insertion: a cadaver study.
Anterior cruciate ligament reconstruction creating the femoral tunnel through the anteromedial portal. Surgical technique. Curr Rev Musculoskelet Med. Lubowitz JH. Anteromedial portal technique for the anterior cruciate ligament femoral socket: pitfalls and solutions. The effect of oblique femoral tunnel placement on rotational constraint of the knee reconstructed using patellar tendon autografts. The relationship between the angle of the tibial tunnel in the coronal plane and loss of flexion and anterior laxity after anterior cruciate ligament reconstruction.
Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide
Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Comparison between rigid and flexible systems for drilling the femoral tunnel through an anteromedial portal in anterior cruciate ligament reconstruction. Femoral graft bending angle and femoral tunnel geometry of transportal and outside-in techniques in anterior cruciate ligament reconstruction: an in vivo 3-dimensional computed tomography analysis.
The lateral intercondylar ridge--a key to anatomic anterior cruciate ligament reconstruction. J Bone Joint Surg Am. Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume-rendering computed tomography.
Arthroscopically pertinent landmarks for tunnel positioning in single-bundle and double-bundle anterior cruciate ligament reconstructions. Influence of knee flexion angle on femoral tunnel characteristics when drilled through the anteromedial portal during anterior cruciate ligament reconstruction.
Is femoral tunnel length correlated with the intercondylar notch and femoral condyle geometry after double-bundle anterior cruciate ligament reconstruction using the transportal technique? An in vivo computed tomography analysis. Determinants of femoral tunnel length in anterior Cruciate ligament reconstruction: CT analysis of the influence of tunnel orientation on the length.
Knee Surg Relat Res. Comparisons of femoral tunnel position and length in anterior cruciate ligament reconstruction: modified transtibial versus anteromedial portal techniques. Lubowitz JH, Konicek J.
Magnetic resonance imaging after anterior cruciate ligament reconstruction: A practical guide
Anterior cruciate ligament femoral tunnel length: cadaveric analysis comparing anteromedial portal versus outside-in technique. Transtibial versus anteromedial portal drilling for anterior cruciate ligament reconstruction: a cadaveric study of femoral tunnel length and obliquity. Femoral tunnel length in primary anterior cruciate ligament reconstruction using an accessory medial portal. Anterior cruciate ligament femoral tunnel drilling through anteromedial portal: axial plane drill angle affects tunnel length.
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Technique for creating the anterior cruciate ligament femoral socket: optimizing femoral footprint anatomic restoration using outside-in drilling. The sagittal plane angle and tunnel-related complications in double-bundle anterior cruciate ligament reconstruction using the transportal technique: an in vivo imaging study.
The effect of femoral tunnel starting position on tunnel length in anterior cruciate ligament reconstruction: a cadaveric study. Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography.
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The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction. Kobo ebook. About The Author. He gained first international experiences at St. Vincent Hospital, Manhattan, N.
After his graduation in he worked in Orthopaedics and Traumatology at the University Hospital of Mannheim before moving on to Melbou Select Parent Grandparent Teacher Kid at heart. Age of the child I gave this to:. Hours of Play:. Tell Us Where You Are:. Preview Your Review. Thank you. Your review has been submitted and will appear here shortly. Extra Content. Please view eBay estimated delivery times at the top of the listing. We are unable to deliver faster than stated. NOTE: We are unable to offer combined shipping for multiple items purchased.
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