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Knee Surg Sports Traumatol Arthrosc. 2015 Dec;23(12):3482-6. doi: 10.1007/s00167-014-3181-4. Epub 2014 Jul 18.

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

Author information

1
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. bart.muller@live.nl.
2
Universitätsklinik für Unfallchirurgie, Medical University of Vienna, Vienna, Austria.
3
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
4
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.

Abstract

PURPOSE:

To quantify the mean difference in femoral tunnel angle (FTA) as measured on knee radiographs between rigid and flexible tunnel drilling after anatomic anterior cruciate ligament (ACL) reconstruction.

METHODS:

Fifty consecutive patients that underwent primary anatomic ACL reconstruction with a single femoral tunnel drilled with a flexible reamer were included in this study. The control group was comprised of 50 patients all of who underwent primary anatomic ACL reconstruction with a single femoral tunnel drilled with a rigid reamer. All femoral tunnels were drilled through a medial portal to ensure anatomic tunnel placement. The FTA was determined from post-operative anterior-to-posterior (AP) radiographs by two independent observers. A 5° difference between the two mean FTA was considered clinically significant.

RESULTS:

The average FTA, when drilled with a rigid reamer, was 42.0° ± 7.2°. Drilling with a flexible reamer resulted in a mean FTA of 44.7° ± 7.0°. The mean difference of 2.7° was not statistically significant. The intraclass correlation coefficient for inter-tester reliability was 0.895.

CONCLUSIONS:

The FTA can be reliably determined from post-operative AP radiographs and provides a useful and reproducible metric for characterizing femoral tunnel position after both rigid and flexible femoral tunnel drilling. This has implications for post-operative evaluation and preoperative treatment planning for ACL revision surgery.

LEVEL OF EVIDENCE:

IV.

KEYWORDS:

Anterior cruciate ligament (ACL); Anterior cruciate ligament reconstruction; Femoral tunnel angle (FTA); Flexible tunnel drilling

PMID:
25034831
DOI:
10.1007/s00167-014-3181-4
[Indexed for MEDLINE]

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