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Comparative Study
. 2011 Mar;19(3):424-31.
doi: 10.1007/s00167-010-1246-6. Epub 2010 Sep 3.

Anatomical Placement of Double Femoral Tunnels in Anterior Cruciate Ligament Reconstruction: Anteromedial Tunnel First or Posterolateral Tunnel First?

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Comparative Study

Anatomical Placement of Double Femoral Tunnels in Anterior Cruciate Ligament Reconstruction: Anteromedial Tunnel First or Posterolateral Tunnel First?

Shuji Taketomi et al. Knee Surg Sports Traumatol Arthrosc. .

Abstract

Purpose: The purpose of this study was to know which tunnel--the anteromedial (AM) bundle or the posterolateral (PL) bundle--should be prepared first to create the 2 femoral tunnels accurately in anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction.

Methods: Thirty-four patients were divided into 2 groups of 17 depending on the sequence of preparation of the 2 femoral tunnels. In group A, the AM tunnel was prepared first, whereas the PL tunnel was prepared first in group P. ACL reconstruction was performed using a three-dimensional (3-D) fluoroscopy-based navigation system to place the double femoral tunnels through an accessory medial portal. The double femoral socket positioning was evaluated by 3-D computed tomography (CT) scan image.

Results: The non-anatomical placement of the femoral sockets occurred in 5 patients (29%) in group A, whereas the 2 sockets were placed anatomically in all patients in group P (P < 0.05). Evaluation of the AM and the PL socket location on the 3-D CT images using the quadrant method showed more similar values to the laboratory data in a literature in group P than in group A. No complication occurred in group A, whereas complications such as socket communications or back wall blowout occurred in 5 patients (29%) in group P (P < 0.05).

Conclusion: The sequence of creating 2 femoral tunnels through accessory medial portal affected the resultant location of the sockets and the rate of the complications. When femoral tunnels are prepared with a transportal technique, PL tunnel first technique seems to be superior to AM first technique regarding anatomic placement. However, PL tunnel first technique accompanies the risk of socket communication.

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References

    1. Arthroscopy. 2008 Mar;24(3):276-84 - PubMed
    1. Arthroscopy. 2004 Dec;20(10 ):1015-25 - PubMed
    1. Arthroscopy. 2006 Nov;22(11):1249.e1-4 - PubMed
    1. Arthroscopy. 2008 Oct;24(10 ):1161-7 - PubMed
    1. Arthroscopy. 2008 Oct;24(10 ):1146-51 - PubMed

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