Reconstruction technique affects femoral tunnel placement in ACL reconstruction.

Journal Article (Journal Article)

Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 +/- 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 +/- 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

Full Text

Duke Authors

Cited Authors

  • Kaseta, MK; DeFrate, LE; Charnock, BL; Sullivan, RT; Garrett, WE

Published Date

  • June 2008

Published In

Volume / Issue

  • 466 / 6

Start / End Page

  • 1467 - 1474

PubMed ID

  • 18404292

Pubmed Central ID

  • PMC2384035

Electronic International Standard Serial Number (EISSN)

  • 1528-1132

Digital Object Identifier (DOI)

  • 10.1007/s11999-008-0238-z


  • eng

Conference Location

  • United States