Arthroscopy: The Journal of Arthroscopic & Related Surgery
The effect of oblique femoral tunnel placement on rotational constraint of the knee reconstructed using patellar tendon autografts
Section snippets
Methods
Ten matched pairs of adult human fresh cadaver knees (age range at death, 51 to 86 years; specimens from 7 men, 3 women) were obtained from the Maryland State Anatomy Board. No specimen had evidence of previous surgery or ligamentous injury. In each specimen, the femur and tibia-fibula were transected 15 cm from the lateral joint line and denuded of soft tissue to within 7 cm of the joint line. The knees were placed in plastic bags and stored at −20°C. The knees were allowed to thaw in the
Anterior tibial translation
Knees reconstructed with an oblique femoral tunnel showed no significant differences in anterior tibial translation compared with knees reconstructed with a standard femoral tunnel, regardless of knee flexion angle (Beta = 0.95 for 30° of flexion; Beta = 0.95 for 90° of flexion). All sectioned specimens showed significantly increased anterior tibial translation compared with intact and reconstructed specimens.
External tibial rotation
Knees reconstructed with an oblique femoral tunnel showed no significant difference in
Discussion
The anatomic origin of the ACL is posterior in the sagittal plane and oblique in the coronal plane. Reconstructions that place the femoral attachment in a nonanatomic position have a high incidence of failure.2 In the current study, increasing the coronal plane obliquity of the femoral tunnel to the anatomic origin of the ACL restored rotational stability to the knee. The oblique femoral tunnels (60° from vertical) resulted in internal tibial rotation similar to that measured in the intact
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