Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2014

01.09.2014 | Knee

Clinical outcome of anatomic double-bundle ACL reconstruction and 3D CT model-based validation of femoral socket aperture position

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to evaluate the clinical results of anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction in which anatomic position of femoral socket apertures was validated using three-dimensional (3D) computed tomography (CT) modelling.

Methods

Anatomic DB ACL reconstructions with hamstring autografts were performed in 34 patients. Two femoral sockets were created through a far anteromedial (AM) portal behind the lateral intercondylar ridge with the assistance of intraoperative 3D fluoroscopic navigation. Femoral tunnel aperture positioning was investigated postoperatively using 3D CT images in all patients. Clinical results were also evaluated subjectively and objectively at least up to 2 years.

Results

Measurement of the AM and the posterolateral (PL) femoral socket locations on the 3D CT images using the quadrant method showed that the centre of the AM socket aperture was located at a depth of 21.0 ± 4.1 % and a height of 30.5 ± 9.3 % and that of the PL socket aperture was located at a depth of 31.3 ± 5.8 % and a height of 57.2 ± 7.7 %. The femoral socket locations were considered as anatomic in accordance with previous cadaveric studies examining the positions of ACL femoral insertion site. Subjectively, the mean Lysholm score was 96.9 ± 4.0 points. According to IKDC final objective scores, 26 knees (76 %) were objectively graded as normal, 8 (24 %) as nearly normal, and 0 (0 %) as abnormal or severely abnormal. Postoperative side-to-side anterior translation measured with a KT-2000 arthrometer averaged 0.7 ± 1.2 mm.

Conclusions

DB ACL reconstructions in which femoral socket apertures were validated anatomically using 3D CT provided satisfactory short-term results.

Level of evidence

Case series, Level IV.
Literatur
1.
Zurück zum Zitat 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 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.
Zurück zum Zitat Amis A, Dawkins G (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br 73:260–267PubMed Amis A, Dawkins G (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br 73:260–267PubMed
3.
Zurück zum Zitat Arnoczky S (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed Arnoczky S (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed
4.
Zurück zum Zitat Basdekis G, Christel P, Anne F (2009) Validation of the position of the femoral tunnels in anatomic double-bundle ACL reconstruction with 3-D CT scan. Knee Surg Sports Traumatol Arthrosc 17:1089–1094PubMedCrossRef Basdekis G, Christel P, Anne F (2009) Validation of the position of the femoral tunnels in anatomic double-bundle ACL reconstruction with 3-D CT scan. Knee Surg Sports Traumatol Arthrosc 17:1089–1094PubMedCrossRef
5.
Zurück zum Zitat Bernard M, Hertel P, Hornung H, Cierpinski T (1997) Femoral insertion of the ACL. Radiographic quadrant method. Am J Knee Surg 10:14–21PubMed Bernard M, Hertel P, Hornung H, Cierpinski T (1997) Femoral insertion of the ACL. Radiographic quadrant method. Am J Knee Surg 10:14–21PubMed
6.
Zurück zum Zitat Bird JH, Carmont MR, Dhillon M, Smith N, Brown C, Thompson P, Spalding T (2011) Validation of a new technique to determine midbundle femoral tunnel position in anterior cruciate ligament reconstruction using 3-dimensional computed tomography analysis. Arthroscopy 27:1259–1267PubMedCrossRef Bird JH, Carmont MR, Dhillon M, Smith N, Brown C, Thompson P, Spalding T (2011) Validation of a new technique to determine midbundle femoral tunnel position in anterior cruciate ligament reconstruction using 3-dimensional computed tomography analysis. Arthroscopy 27:1259–1267PubMedCrossRef
7.
Zurück zum Zitat Colombet P, Robinson J (2008) Computer-assisted, anatomic, double-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:1152–1160PubMedCrossRef Colombet P, Robinson J (2008) Computer-assisted, anatomic, double-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:1152–1160PubMedCrossRef
8.
Zurück zum Zitat Colombet P, Robinson J, Christel P, Franceschi J, Djian P, Bellier G, Sbihi A (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef Colombet P, Robinson J, Christel P, Franceschi J, Djian P, Bellier G, Sbihi A (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef
9.
Zurück zum Zitat Ferretti M, Doca D, Ingham SM, Cohen M, Fu FH (2012) Bony and soft tissue landmarks of the ACL tibial insertion site: an anatomical study. Knee Surg Sports Traumatol Arthrosc 20:62–68PubMedCrossRef Ferretti M, Doca D, Ingham SM, Cohen M, Fu FH (2012) Bony and soft tissue landmarks of the ACL tibial insertion site: an anatomical study. Knee Surg Sports Traumatol Arthrosc 20:62–68PubMedCrossRef
10.
Zurück zum Zitat Ferretti M, Ekdahl M, Shen W, Fu F (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef Ferretti M, Ekdahl M, Shen W, Fu F (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef
11.
Zurück zum Zitat Forsythe B, Kopf S, Wong A, Martins C, Anderst W, Tashman S, Fu F (2010) The location of femoral and tibial tunnels in anatomic double-bundle anterior cruciate ligament reconstruction analyzed by three-dimensional computed tomography models. J Bone Joint Surg Am 92:1418–1426PubMedCrossRef Forsythe B, Kopf S, Wong A, Martins C, Anderst W, Tashman S, Fu F (2010) The location of femoral and tibial tunnels in anatomic double-bundle anterior cruciate ligament reconstruction analyzed by three-dimensional computed tomography models. J Bone Joint Surg Am 92:1418–1426PubMedCrossRef
12.
Zurück zum Zitat Fu F, Jordan S (2007) The lateral intercondylar ridge—a key to anatomic anterior cruciate ligament reconstruction. J Bone Joint Surg Am 89:2103–2104PubMedCrossRef Fu F, Jordan S (2007) The lateral intercondylar ridge—a key to anatomic anterior cruciate ligament reconstruction. J Bone Joint Surg Am 89:2103–2104PubMedCrossRef
13.
Zurück zum Zitat Galway H, MacIntosh D (1980) The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency. Clin Orthop Relat Res 147:45–50PubMed Galway H, MacIntosh D (1980) The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency. Clin Orthop Relat Res 147:45–50PubMed
14.
Zurück zum Zitat Giron F, Cuomo P, Aglietti P, Bull A, Amis A (2006) Femoral attachment of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 14:250–256PubMedCrossRef Giron F, Cuomo P, Aglietti P, Bull A, Amis A (2006) Femoral attachment of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 14:250–256PubMedCrossRef
15.
Zurück zum Zitat Hoser C, Tecklenburg K, Kuenzel KH, Fink C (2005) Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography. Knee Surg Sports Traumatol Arthrosc 13:256–262PubMedCrossRef Hoser C, Tecklenburg K, Kuenzel KH, Fink C (2005) Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography. Knee Surg Sports Traumatol Arthrosc 13:256–262PubMedCrossRef
16.
Zurück zum Zitat Iriuchishima T, Ingham SJ, Tajima G, Horaguchi T, Saito A, Tokuhashi Y, Van Houten AH, Aerts MM, Fu FH (2010) Evaluation of the tunnel placement in the anatomical double-bundle ACL reconstruction: a cadaver study. Knee Surg Sports Traumatol Arthrosc 18:1226–1231PubMedCrossRef Iriuchishima T, Ingham SJ, Tajima G, Horaguchi T, Saito A, Tokuhashi Y, Van Houten AH, Aerts MM, Fu FH (2010) Evaluation of the tunnel placement in the anatomical double-bundle ACL reconstruction: a cadaver study. Knee Surg Sports Traumatol Arthrosc 18:1226–1231PubMedCrossRef
17.
Zurück zum Zitat Irrgang J, Anderson A, Boland A, Harner C, Kurosaka M, Neyret P, Richmond J, Shelborne K (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29:600–613PubMed Irrgang J, Anderson A, Boland A, Harner C, Kurosaka M, Neyret P, Richmond J, Shelborne K (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29:600–613PubMed
18.
Zurück zum Zitat Kawakami Y, Hiranaka T, Matsumoto T, Hida Y, Fukui T, Uemoto H, Doita M, Tsuji M, Kurosaka M, Kuroda R (2012) The accuracy of bone tunnel position using fluoroscopic-based navigation system in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1503–1510PubMedCrossRef Kawakami Y, Hiranaka T, Matsumoto T, Hida Y, Fukui T, Uemoto H, Doita M, Tsuji M, Kurosaka M, Kuroda R (2012) The accuracy of bone tunnel position using fluoroscopic-based navigation system in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1503–1510PubMedCrossRef
19.
Zurück zum Zitat Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36:1675–1687PubMedCrossRef Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36:1675–1687PubMedCrossRef
20.
Zurück zum Zitat Kopf S, Forsythe B, Wong AK, Tashman S, Irrgang JJ, Fu FH (2012) Transtibial ACL reconstruction technique fails to position drill tunnels anatomically in vivo 3D CT study. Knee Surg Sports Traumatol Arthrosc 20:2200–2207PubMedCentralPubMedCrossRef Kopf S, Forsythe B, Wong AK, Tashman S, Irrgang JJ, Fu FH (2012) Transtibial ACL reconstruction technique fails to position drill tunnels anatomically in vivo 3D CT study. Knee Surg Sports Traumatol Arthrosc 20:2200–2207PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Lee YS, Sim JA, Kwak JH, Nam SW, Kim KH, Lee BK (2012) Comparative analysis of femoral tunnels between outside-in and transtibial double-bundle anterior cruciate ligament reconstruction: a 3-dimensional computed tomography study. Arthroscopy 28:1417–1423PubMedCrossRef Lee YS, Sim JA, Kwak JH, Nam SW, Kim KH, Lee BK (2012) Comparative analysis of femoral tunnels between outside-in and transtibial double-bundle anterior cruciate ligament reconstruction: a 3-dimensional computed tomography study. Arthroscopy 28:1417–1423PubMedCrossRef
22.
Zurück zum Zitat Lertwanich P, Martins CA, Asai S, Ingham SJ, Smolinski P, Fu FH (2011) Anterior cruciate ligament tunnel position measurement reliability on 3-dimensional reconstructed computed tomography. Arthroscopy 27:391–398PubMedCrossRef Lertwanich P, Martins CA, Asai S, Ingham SJ, Smolinski P, Fu FH (2011) Anterior cruciate ligament tunnel position measurement reliability on 3-dimensional reconstructed computed tomography. Arthroscopy 27:391–398PubMedCrossRef
23.
Zurück zum Zitat Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef
24.
Zurück zum Zitat Muneta T, Koga H, Mochizuki T, Ju Y, Hara K, Nimura A, Yagishita K, Sekiya I (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 Muneta T, Koga H, Mochizuki T, Ju Y, Hara K, Nimura A, Yagishita K, Sekiya I (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
25.
Zurück zum Zitat Musahl V, Plakseychuk A, VanScyoc A, Sasaki T, Debski RE, McMahon PJ, Fu FH (2005) Varying femoral tunnels between the anatomical footprint and isometric positions: effect on kinematics of the anterior cruciate ligament-reconstructed knee. Am J Sports Med 33:712–718PubMedCrossRef Musahl V, Plakseychuk A, VanScyoc A, Sasaki T, Debski RE, McMahon PJ, Fu FH (2005) Varying femoral tunnels between the anatomical footprint and isometric positions: effect on kinematics of the anterior cruciate ligament-reconstructed knee. Am J Sports Med 33:712–718PubMedCrossRef
26.
Zurück zum Zitat Nakagawa T, Takeda H, Nakajima K, Nakayama S, Fukai A, Kachi Y, Kawano H, Miura T, Nakamura K (2008) Intraoperative 3-dimensional imaging-based navigation-assisted anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:1161–1167PubMedCrossRef Nakagawa T, Takeda H, Nakajima K, Nakayama S, Fukai A, Kachi Y, Kawano H, Miura T, Nakamura K (2008) Intraoperative 3-dimensional imaging-based navigation-assisted anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:1161–1167PubMedCrossRef
27.
Zurück zum Zitat Nakajima H, Kondo M, Kurosawa H, Fukubayashi T (1979) Insufficiency of the anterior cruciate ligament. Review of our 118 cases. Arch Orthop Trauma Surg 95:233–240PubMedCrossRef Nakajima H, Kondo M, Kurosawa H, Fukubayashi T (1979) Insufficiency of the anterior cruciate ligament. Review of our 118 cases. Arch Orthop Trauma Surg 95:233–240PubMedCrossRef
28.
Zurück zum Zitat Papannagari R, Gill T, Defrate L, Moses J, Petruska A, Li G (2006) In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation. Am J Sports Med 34:2006–2012PubMedCrossRef Papannagari R, Gill T, Defrate L, Moses J, Petruska A, Li G (2006) In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation. Am J Sports Med 34:2006–2012PubMedCrossRef
29.
Zurück zum Zitat Sadoghi P, Kropfl A, Jansson V, Muller PE, Pietschmann MF, Fischmeister MF (2011) Impact of tibial and femoral tunnel position on clinical results after anterior cruciate ligament reconstruction. Arthroscopy 27:355–364PubMedCrossRef Sadoghi P, Kropfl A, Jansson V, Muller PE, Pietschmann MF, Fischmeister MF (2011) Impact of tibial and femoral tunnel position on clinical results after anterior cruciate ligament reconstruction. Arthroscopy 27:355–364PubMedCrossRef
30.
Zurück zum Zitat Shino K, Horibe S, Hamada M, Nakamura N, Nakata K, Toritsuka Y, Mae T (2002) Allograft anterior cruciate ligament reconstruction. Tech Knee Surg 1:78–85CrossRef Shino K, Horibe S, Hamada M, Nakamura N, Nakata K, Toritsuka Y, Mae T (2002) Allograft anterior cruciate ligament reconstruction. Tech Knee Surg 1:78–85CrossRef
31.
Zurück zum Zitat Shino K, Suzuki T, Iwahashi T, Mae T, Nakamura N, Nakata K, Nakagawa S (2010) The resident’s ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1164–1168PubMedCrossRef Shino K, Suzuki T, Iwahashi T, Mae T, Nakamura N, Nakata K, Nakagawa S (2010) The resident’s ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1164–1168PubMedCrossRef
32.
Zurück zum Zitat Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145PubMedCrossRef Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145PubMedCrossRef
33.
Zurück zum Zitat Taketomi S, Inui H, Nakamura K, Hirota J, Takei S, Takeda H, Tanaka S, Nakagawa T (2012) Three-dimensional fluoroscopic navigation guidance for femoral tunnel creation in revision anterior cruciate ligament reconstruction. Arthrosc Tech 1:e95–e99PubMedCentralPubMedCrossRef Taketomi S, Inui H, Nakamura K, Hirota J, Takei S, Takeda H, Tanaka S, Nakagawa T (2012) Three-dimensional fluoroscopic navigation guidance for femoral tunnel creation in revision anterior cruciate ligament reconstruction. Arthrosc Tech 1:e95–e99PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Taketomi S, Nakagawa T, Takeda H, Nakajima K, Nakayama S, Fukai A, Hirota J, Kachi Y, Kawano H, Miura T, Fukui N, Nakamura K (2011) Anatomical placement of double femoral tunnels in anterior cruciate ligament reconstruction: anteromedial tunnel first or posterolateral tunnel first? Knee Surg Sports Traumatol Arthrosc 19:424–431PubMedCrossRef Taketomi S, Nakagawa T, Takeda H, Nakajima K, Nakayama S, Fukai A, Hirota J, Kachi Y, Kawano H, Miura T, Fukui N, Nakamura K (2011) Anatomical placement of double femoral tunnels in anterior cruciate ligament reconstruction: anteromedial tunnel first or posterolateral tunnel first? Knee Surg Sports Traumatol Arthrosc 19:424–431PubMedCrossRef
35.
Zurück zum Zitat Tashiro Y, Okazaki K, Miura H, Matsuda S, Yasunaga T, Hashizume M, Nakanishi Y, Iwamoto Y (2009) Quantitative assessment of rotatory instability after anterior cruciate ligament reconstruction. Am J Sports Med 37:909–916PubMedCrossRef Tashiro Y, Okazaki K, Miura H, Matsuda S, Yasunaga T, Hashizume M, Nakanishi Y, Iwamoto Y (2009) Quantitative assessment of rotatory instability after anterior cruciate ligament reconstruction. Am J Sports Med 37:909–916PubMedCrossRef
36.
Zurück zum Zitat Tensho K, Kodaira H, Yasuda G, Yoshimura Y, Narita N, Morioka S, Kato H, Saito N (2011) Anatomic double-bundle anterior cruciate ligament reconstruction, using CT-based navigation and fiducial markers. Knee Surg Sports Traumatol Arthrosc 19:378–383PubMedCrossRef Tensho K, Kodaira H, Yasuda G, Yoshimura Y, Narita N, Morioka S, Kato H, Saito N (2011) Anatomic double-bundle anterior cruciate ligament reconstruction, using CT-based navigation and fiducial markers. Knee Surg Sports Traumatol Arthrosc 19:378–383PubMedCrossRef
37.
Zurück zum Zitat Toritsuka Y, Amano H, Kuwano M, Iwai T, Mae T, Ohzono K, Shino K (2009) Outcome of double-bundle ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 17:456–463PubMedCrossRef Toritsuka Y, Amano H, Kuwano M, Iwai T, Mae T, Ohzono K, Shino K (2009) Outcome of double-bundle ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 17:456–463PubMedCrossRef
38.
Zurück zum Zitat Tsuda E, Ishibashi Y, Fukuda A, Yamamoto Y, Tsukada H, Ono S (2010) Tunnel position and relationship to postoperative knee laxity after double-bundle anterior cruciate ligament reconstruction with a transtibial technique. Am J Sports Med 38:698–706PubMedCrossRef Tsuda E, Ishibashi Y, Fukuda A, Yamamoto Y, Tsukada H, Ono S (2010) Tunnel position and relationship to postoperative knee laxity after double-bundle anterior cruciate ligament reconstruction with a transtibial technique. Am J Sports Med 38:698–706PubMedCrossRef
39.
Zurück zum Zitat van Eck CF, Morse KR, Lesniak BP, Kropf EJ, Tranovich MJ, van Dijk CN, Fu FH (2010) Does the lateral intercondylar ridge disappear in ACL deficient patients? Knee Surg Sports Traumatol Arthrosc 18:1184–1188PubMedCentralPubMedCrossRef van Eck CF, Morse KR, Lesniak BP, Kropf EJ, Tranovich MJ, van Dijk CN, Fu FH (2010) Does the lateral intercondylar ridge disappear in ACL deficient patients? Knee Surg Sports Traumatol Arthrosc 18:1184–1188PubMedCentralPubMedCrossRef
40.
Zurück zum Zitat van Eck CF, Schreiber VM, Mejia HA, Samuelsson K, van Dijk CN, Karlsson J, Fu FH (2010) “Anatomic” anterior cruciate ligament reconstruction: a systematic review of surgical techniques and reporting of surgical data. Arthroscopy 26:S2–12PubMedCrossRef van Eck CF, Schreiber VM, Mejia HA, Samuelsson K, van Dijk CN, Karlsson J, Fu FH (2010) “Anatomic” anterior cruciate ligament reconstruction: a systematic review of surgical techniques and reporting of surgical data. Arthroscopy 26:S2–12PubMedCrossRef
41.
Zurück zum Zitat 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 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
42.
Zurück zum Zitat Zantop T, Diermann N, Schumacher T, Schanz S, Fu F, Petersen W (2008) Anatomical and nonanatomical double-bundle anterior cruciate ligament reconstruction: importance of femoral tunnel location on knee kinematics. Am J Sports Med 36:678–685PubMedCrossRef Zantop T, Diermann N, Schumacher T, Schanz S, Fu F, Petersen W (2008) Anatomical and nonanatomical double-bundle anterior cruciate ligament reconstruction: importance of femoral tunnel location on knee kinematics. Am J Sports Med 36:678–685PubMedCrossRef
43.
Zurück zum Zitat Zantop T, Wellmann M, Fu F, 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 Zantop T, Wellmann M, Fu F, 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
44.
Zurück zum Zitat Zhao J, Peng X, He Y, Wang J (2006) Two-bundle anterior cruciate ligament reconstruction with eight-stranded hamstring tendons: four-tunnel technique. Knee 13:36–41PubMedCrossRef Zhao J, Peng X, He Y, Wang J (2006) Two-bundle anterior cruciate ligament reconstruction with eight-stranded hamstring tendons: four-tunnel technique. Knee 13:36–41PubMedCrossRef
Metadaten
Titel
Clinical outcome of anatomic double-bundle ACL reconstruction and 3D CT model-based validation of femoral socket aperture position
Publikationsdatum
01.09.2014
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2014
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2663-0

Weitere Artikel der Ausgabe 9/2014

Knee Surgery, Sports Traumatology, Arthroscopy 9/2014 Zur Ausgabe

Arthropedia

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

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.