Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleTibial Tunnel Placement Accuracy During Anterior Cruciate Ligament Reconstruction: Independent Femoral Versus Transtibial Femoral Tunnel Drilling Techniques
Section snippets
Methods
The bilateral knees of 10 cadavers (N = 20 knees) were used for the study. We randomized each pair of cadaveric knees to receive arthroscopic TT drilling on one side and IF drilling on the other side. Care was taken in the randomization process to ensure that equal numbers of each technique were performed on left and right knees. We chose a quantity of 20 specimens as being in line with similar previous studies.11, 12 All tunnels in this study were drilled with an 8-mm reamer. Although some
Results
Results of the comparisons between preintervention and postintervention scans are summarized in Table 1, Table 2. There was a statistically significant difference with respect to the percentage of the tibial tunnel aperture placed within the native footprint. Although not statistically significant, the distance from the center of the tibial tunnel aperture to the center of the tibial ACL footprint tended to be less in the IF group compared with the TT group. The TT drilling technique tended to
Discussion
Results from this study indicate that the tibial tunnel aperture can be placed more accurately in the native ACL tibial insertion using the IF technique compared with the TT technique. More than 71% of the tibial tunnel aperture was placed within the native ACL footprint using the IF technique, which was significantly more than the 52% overlap in the TT technique. Also, although not statistically significant, the distance from the center of the tibial tunnel aperture to the center of the tibial
Conclusions
This study showed that TT drilling with an 8-mm reamer has deleterious effects on tibial tunnel aperture and position. IF drilling, which does not involve repeated reaming of the tibial tunnel, is associated with the placement of a higher percentage of tunnel aperture within the native tibial footprint. There was not a significant difference between the IF and TT techniques in their ability to place the center of the tibial aperture near the center of the footprint or in graft obliquity.
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Cited by (0)
The authors report the following potential conflict of interest or source of funding in relation to this article: S.B. receives support from MicroAire; M.D.M. receives support from Pediatric Orthopaedic Society of North America.