Postoperative radiographic evaluation of Tibial ACL footprint after single bundle Anatomic ACL reconstruction: By the lateral meniscus as reference point
Keywords:
Anterior cruciate ligament footprint, ACL tibial landmarkAbstract
Context: The anatomic ACL reconstruction technique helps to resolve problematic knee instability from an ACL injury, providing an excellent result for both single-bundle and doublebundle techniques.
Purpose: To confirm that the tibial ACL tunnel creates, by the posterior edge of the lateral meniscus a reliable arthroscopic reference point, i.e., as compared with postoperative evidencebased radiography.
Materials and Methods: This descriptive retrospective study collected data from 20 ACL deficient patients at Phramongkutklao hospital between January 2012 and December 2014. These 20 patients underwent anatomic single-bundle ACL reconstruction by one surgeon,
whereby the tibial tunnel was created with the lateral meniscus and medial tibial spine as reference points. Both a postoperative radiograph and CT-3D reconstruction were used to further evaluate the tibial tunnel position and the results were compared with supporting literature.
Results: The postoperative plain x-ray lateral view showed the centrum of the tibial ACL tunnel was 32.8±4.7%; the AP view showed the centrum of the tibial ACL tunnel at 41.1±2.4%. The postoperative CT-3D reconstruction showed the centrum of the tibial ACL tunnel from the anterior was 36.5±5.6% -- and from the medial the centrum was 44.9±3.0%. These were all within the acceptable range according to literature.
Conclusions: The medial tibial eminence and posterior border of the LM were reliable arthroscopic landmarks for determining the tibial tunnel, in single anatomical ACL reconstruction technique.
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