Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Knee Surgery, Sports Traumatology, Arthroscopy
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2011

01.04.2011 | Knee

Avoiding tunnel collisions between fibular collateral ligament and ACL posterolateral bundle reconstruction

verfasst von: Lawrence Camarda, Michele D′Arienzo, Giovanni Palermo Patera, Leone Filosto, Robert F. LaPrade

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to evaluate the risk of tunnel collisions of the fibular collateral ligament (FCL) and posterolateral bundle anterior cruciate ligament (PLB-ACL) tunnels during a combined FCL and double-dundle (DB) ACL reconstruction.

Methods

Thirty-six 4th-generation synthetic femurs (Sawbones, Pacific Research Laboratories, Vashon, WA) were utilized, and two different femur sizes were used. A FCL tunnel and a PLB-ACL tunnel were reamed on each femur. The tunnels of synthetic specimens that did not have a collision were filled with an epoxy resin augmented with BaSO4 and radiographic evaluation, and Multidetector CT exams of the specimens were performed.

Results

The rate of tunnel collision when the FCL tunnel was reamed to a depth of 30 mm was 75 and 69.4% for the 25 mm depth. There was a significantly increased risk of tunnel collision when the FCL tunnel was reamed proximally with coronal angulations of 20° and 40°. No collisions were noted when the FCL tunnel was reamed parallel to the distal condylar line and with axial angulations of 20° and 40°.

Conclusion

This study provides new insight into tunnel positioning during a combined FCL and DB-ACL reconstruction. The results show that a concomitant FCL injury do not represent a contraindication to perform a DB-ACL reconstruction as long as the FCL tunnel is reamed with no proximal angulation and is directed anteriorly with an axial angulation between 20° and 40°.
Literatur
1.
Aglietti P, Giron F, Cuomo P, Losco M, Mondanelli N (2007) Single-and double-incision double-bundle ACL reconstruction. Clin Orthop Relat Res 454:108–113PubMedCrossRef
2.
Basdekis G, Abisafi C, Christel P (2008) Influence of knee flexion angle on femoral tunnel characteristics when drilled through the anteromedial portal during anterior cruciate ligament reconstruction. Arthroscopy 24:459–464PubMedCrossRef
3.
Basdekis G, Abisafi C, Christel P (2009) Effect of knee flexion angle on length and orientation of posterolateral femoral tunnel drilled through anteromedial portal during anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 25:1108–1114PubMedCrossRef
4.
Belisle AL, Bicos J, Geaney L et al (2007) Strain pattern comparison of double- and single-bundle anterior cruciate ligament reconstruction techniques with the native anterior cruciate ligament. Arthroscopy 23:1210–1217PubMedCrossRef
5.
Cha PS, Brucker PU, West RV et al (2005) Arthroscopic double-bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy 21:1275PubMedCrossRef
6.
Farrow LD, Parker RD (2010) The relationship of lateral anatomic structures to exiting guide pins during femoral tunnel preparation utilizing an accessory medial portal. Knee Surg Sports Traumatol Arthrosc 18:747–753PubMedCrossRef
7.
Fu FH, Shen W, Starman JS, Okeke N, Irrgang JJ (2008) Primary anatomic double-bundle anterior cruciate ligament reconstruction: a preliminary 2-year prospective study. Am J Sports Med 36:1263–1274PubMedCrossRef
8.
Gelber PE, Reina F, Torres R, Pelfort X, Tey M, Monllau JC (2010) Anatomic single-bundle anterior cruciate ligament reconstruction from the anteromedial portal: evaluation of transverse femoral fixation in a cadaveric model. Arthroscopy 26:651–657PubMedCrossRef
9.
Hall MP, Ryzewicz M, Walsh PJ, Sherman OH (2009) Risk of iatrogenic injury to the peroneal nerve during posterolateral femoral tunnel placement in double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 37:109–113PubMedCrossRef
10.
Hamada M, Shino K, Horibe S et al (2001) Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endoButton femoral fixation: prospective study. Arthroscopy 17:801–807PubMedCrossRef
11.
Jarvela T (2007) Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc 15:500–507PubMedCrossRef
12.
LaPrade RF, Resig S, Wentorf F, Lewis JL (1999) The effects of grade III posterolateral knee complex injuries on anterior cruciate ligament graft force. A biomechanical analysis. Am J Sports Med 27:469–475PubMed
13.
LaPrade RF, Johansen S, Wentorf FA, Engebretsen L, Esterberg JL, Tso A (2004) An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique. Am J Sports Med 32:1405–1414PubMedCrossRef
14.
Lee SH, Jung YB, Jung HJ, Song KS, Ko YB (2010) Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc 18:1219–1225PubMedCrossRef
15.
Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamamoto H, Shinomiya K (1999) Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy 15:618–624PubMedCrossRef
16.
Muneta T, Koga H, Mochizuki T et al (2007) A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy 23:618–628PubMedCrossRef
17.
Nakagawa T, Takeda H, Nakajima K et al (2008) Intraoperative 3-dimensional imaging-based navigation-assisted anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:1161–1167PubMedCrossRef
18.
Nakamura M, Deie M, Shibuya H et al (2009) Potential risks of femoral tunnel drilling through the far anteromedial portal: a cadaveric study. Arthroscopy 25:481–487PubMedCrossRef
19.
Neven E, D’Hooghe P, Bellemans J (2008) Double-bundle anterior cruciate ligament reconstruction: a cadaveric study on the posterolateral tunnel position and safety of the lateral structures. Arthroscopy 24:436–440PubMedCrossRef
20.
O’Brien SJ, Warren RF, Pavlov H, Panariello R, Wickiewicz TL (1991) Reconstruction of the chronically insufficient anterior cruciate ligament with the central third of the patellar ligament. J Bone Joint Surg Am 73:278–286PubMed
21.
Petersen W, Tretow H, Weimann A et al (2007) Biomechanical evaluation of two techniques for double-bundle anterior cruciate ligament reconstruction: one tibial tunnel versus two tibial tunnels. Am J Sports Med 35:228–234PubMedCrossRef
22.
Pietrini SD, LaPrade RF, Griffith CJ, Wijdicks CA, Ziegler CG (2009) Radiographic identification of the primary posterolateral knee structures. Am J Sports Med 37:542–551PubMedCrossRef
23.
Pombo MW, Shen W, Fu FH (2008) Anatomic double-bundle anterior cruciate ligament reconstruction: where are we today? Arthroscopy 24:1168–1177PubMedCrossRef
24.
Shen W, Jordan S, Fu F (2007) Review article: anatomic double bundle anterior cruciate ligament reconstruction. J Orthop Surg (Hong Kong) 15:216–221
25.
Shuler MS, Jasper LE, Rauh PB, Mulligan ME, Moorman CT III (2006) Tunnel convergence in combined anterior cruciate ligament and posterolateral corner reconstruction. Arthroscopy 22:193–198PubMedCrossRef
26.
Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145PubMedCrossRef
27.
Tsai AG, Wijdicks CA, Walsh MP, Laprade RF (2010) Comparative kinematic evaluation of all-inside single-bundle and double-bundle anterior cruciate ligament reconstruction: a biomechanical study. Am J Sports Med 38:263–272PubMedCrossRef
28.
Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107PubMedCrossRef
29.
Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed
30.
Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2006) Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy 22:240–251PubMedCrossRef
31.
Yasuda K, Kondo E, Ichiyama H et al (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025PubMedCrossRef
32.
Zantop T, Wellmann M, Fu FH, Petersen W (2008) Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings. Am J Sports Med 36:65–72PubMedCrossRef
33.
Zantop T, Kubo S, Petersen W, Musahl V, Fu FH (2007) Current techniques in anatomic anterior cruciate ligament reconstruction. Arthroscopy 23:938–947PubMedCrossRef
Metadaten
Titel
Avoiding tunnel collisions between fibular collateral ligament and ACL posterolateral bundle reconstruction
verfasst von
Lawrence Camarda
Michele D′Arienzo
Giovanni Palermo Patera
Leone Filosto
Robert F. LaPrade
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 4/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1299-6

Weitere Artikel der Ausgabe 4/2011

Knee Surgery, Sports Traumatology, Arthroscopy 4/2011 Zur Ausgabe

Knee

Relationship between quadriceps femoris muscle volume and muscle torque after anterior cruciate ligament rupture

Ankle

Percutaneous decompression for the treatment of Mueller–Weiss syndrome

Knee

ACL injury prevention, more effective with a different way of motor learning?

Knee

Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report

Editorial

Injection treatment for chronic midportion Achilles tendinopathy: do we need that many alternatives?

Knee

Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise