Influences of knee flexion angle and portal position on the location of femoral tunnel outlet in anterior cruciate ligament reconstruction with anteromedial portal technique

Kanji Osaki, Ken Okazaki, Yasutaka Tashiro, Hirokazu Matsubara, Yukihide Iwamoto

研究成果: Contribution to journalArticle査読

12 被引用数 (Scopus)

抄録

Purpose: To evaluate the influences of knee flexion angle and portal position on the location of femoral tunnel outlet in anterior cruciate ligament (ACL) reconstruction with the anteromedial (AM) portal technique. Methods: We recruited 6 volunteers with 12 normal knees. Each knee was flexed 120° or 135° and scanned with an open MRI. A 3D knee model was created. Virtual femoral tunnels were created on the footprint of the AM bundle and the posterolateral (PL) bundle of the ACL from three arthroscopic portals: the standard AM portal, the far medial and low portal, and the far medial and high (FMH) portal. The location of the femoral tunnel outlet was evaluated by comparing to the dissected cadaveric knee. Results: Both increased flexion angle and lowering the drilling portal have a similar influence on the femoral tunnel outlet by moving them anterior and distally. Medialization of the portal moves them posteriorly and distally. PL tunnels created on the 120° knee model are more likely to be located under the lateral head of the gastrocnemius especially when they are drilled through the AM or FMH portals. Conclusion: If the femoral tunnel outlet is located under the soft tissue such as gastrocnemius attachment, suspension fixation devices may lapse into fixation failure by sitting on the soft tissue rather than the cortex bone surface. It is more desirable to drill in 135° knee flexion rather than 120°, and through a lower portal, to avoid creating the femoral tunnel outlet under soft tissues. Type of study: Experimental research.

本文言語英語
ページ(範囲)777-784
ページ数8
ジャーナルKnee Surgery, Sports Traumatology, Arthroscopy
23
3
DOI
出版ステータス出版済み - 2015

All Science Journal Classification (ASJC) codes

  • 外科
  • 整形外科およびスポーツ医学

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