Comparison of femoral tunnel position and knee function in anterior cruciate ligament reconstruction: a retrospective cohort study using measuring-fluoroscopy method versus bony marker method.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Anterior Cruciate Ligament Reconstruction*/methods ; Femur*/surgery ; Femur*/diagnostic imaging ; Anterior Cruciate Ligament Injuries*/surgery ; Knee Joint*/surgery ; Knee Joint*/diagnostic imaging ; Knee Joint*/physiopathology; Humans ; Retrospective Studies ; Female ; Fluoroscopy/methods ; Male ; Adult ; Young Adult ; Arthroscopy/methods ; Adolescent ; Anterior Cruciate Ligament/surgery ; Anterior Cruciate Ligament/diagnostic imaging ; Treatment Outcome ; Range of Motion, Articular

Background: Previous studies have shown that surgical technique errors especially the wrong bone tunnel position are the primary reason for the failure of anterior cruciate ligament (ACL) reconstruction. In this study, we aimed to compare the femoral tunnel position and impact on knee function during the ACL reconstruction using measuring combined with fluoroscopy method and bony marker method for femoral tunnel localization.
Methods: A retrospective cohort study of patients undergoing ACL reconstruction using the bony marker method or measuring combined with fluoroscopy for femoral tunnel localization was conducted between January 2015 and January 2020. A second arthroscopic exploration was performed more than 1 year after surgery. Data regarding patient demographics, the femoral tunnel position, results of the Lysholm score, the International Knee Documentation Committee (IKDC) score, KT-1000 side-to-side difference, pivot shift grade, and Lachman grade of the knee were collected.
Results: A total of 119 patients were included in the final cohort. Of these, 42 cases were in the traditional method group, and 77 cases were in the measuring method group. The good tunnel position rate was 26.2% in the traditional method group and 81.8% in the measuring method group (p < 0.001). At the final follow-up, the Lysholm and IKDC scores were significantly greater in the measuring method group than the traditional method group (IKDC: 84.9 ± 8.4 vs. 79.6 ± 6.4, p = 0.0005; Lysholm: 88.8 ± 6.4 vs. 81.6 ± 6.4, p < 0.001). Lachman and pivot shift grades were significantly greater in the measuring method group (p = 0.01, p = 0008). The results of KT-1000 side-to-side differences were significantly better in the measuring method group compared with those in the traditional method group (p < 0.001).
Conclusions: The combination of the measuring method and intraoperative fluoroscopy resulted in a concentrated tunnel position on the femoral side, a high rate of functional success, improved knee stability, and a low risk of tunnel deviation. This approach is particularly suitable for surgeons new to ACL reconstructive surgery.
(© 2024. The Author(s).)

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Keywords: ACL rupture; Anatomical reconstruction; Apex; Bony landmarks; Cartilage; Fluoroscopy; Function; Measuring method

Date Created: 20240723 Date Completed: 20240724 Latest Revision: 20240727

20240727

PMC11264435

10.1186/s12891-024-07684-8

39044221