ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
The effect of intraoperative fluoroscopy on the accuracy of femoral tunnel placement in single-bundle anatomic ACL reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Superior accuracy of femoral bone tunnel drilling in robot-assisted anterior cruciate ligament reconstruction: a multicenter, randomized, controlled trial.International journal of surgery (London, England) · 2025Trial
- Intra-operative fluoroscopic measurement accuracy for femoral tunnel aperture positions in anterior cruciate ligament reconstruction.BMC musculoskeletal disorders · 2026Article
- Improvement of Accuracy of Femoral Tunnel Positioning in ACL Surgery for Low-Volume Surgeons Using Intraoperative Fluoroscopy.Orthopaedic journal of sports medicine · 2025Article
- Surgical Robots Improve Tunnel Angle and Graft Bending Angle in Anatomic ACL Reconstruction: A Multicenter Study.Bioengineering (Basel, Switzerland) · 2025Article
- 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.BMC musculoskeletal disorders · 2024Article
- App-based analysis of the femoral tunnel position in ACL reconstruction using the quadrant method.Archives of orthopaedic and trauma surgery · 2024Article
- A comparative study on 3D printing-assisted arthroscopic IDEAL point femoral tunnel positioning for anterior cruciate ligament reconstruction versus conventional arthroscopic positioning.BMC musculoskeletal disorders · 2024Article
- App-Based Analysis of Fluoroscopic Images According to Bernard-Hertel Method for the Determination of Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2024Article
- Patient specific instrumentation in ACL reconstruction: a proof-of-concept cadaver experiment assessing drilling accuracy when using 3D printed guides.Archives of orthopaedic and trauma surgery · 2024Article
- Grid and Image Intensifier Improve Arthroscopic ACL Tunnel Position and Patient-Reported Outcomes.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- Femoral Tunnel Placement Analysis in ACL Reconstruction Through Use of a Novel 3-Dimensional Reference With Biplanar Stereoradiographic Imaging.Orthopaedic journal of sports medicine · 2020Article
- Intraoperative fluoroscopy reduces the variability in femoral tunnel placement during single-bundle anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Femoral offset guide facilitates accurate and precise femoral tunnel placement for single-bundle anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- 3-Dimensional Printed Models May Be a Useful Tool When Planning Revision Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2019Article
- Accurate Positioning of Femoral and Tibial Tunnels in Single Bundle Anterior Cruciate Ligament Reconstruction Using the Indigenously Made Bernard and Hurtle Grid on a Transparency Sheet and C-arm.Arthroscopy techniques · 2017Article
- Augmented Reality With Dynamic Anatomy Modelling for Knee Arthroscopy.Healthcare technology lettersArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the current study was to investigate the potential effect of intraoperative fluoroscopy on the accuracy of femoral tunnel placement in anatomic ACL reconstruction, using an ideal anatomic point as reference and evaluating postoperative tunnel placement based on 3D CT.
methodsAn experienced ACL surgeon, using the anatomic approach for femoral tunnel placement, relying on intraarticular landmarks and remnants of the torn ACL-and novel to the fluoroscopic assist-was introduced to its use. A prospective series of patients was included where group 1 (without fluoroscopy) and group 2 (with fluoroscopy) both had postoperative CT scans so that femoral tunnel position could be evaluated and compared to an ideal tunnel centre based on anatomic studies by using the Bernard and Hertel grid.
resultsGroup 2, where fluoroscopy was used, had a mean femoral tunnel that was closer to the ideal anatomic centre than group 1. In the Bernard and Hertel grid, the distance in the high-low axis (y-axis) was found significantly closer (P = 0.001), whilst the deep-shallow axis (x-axis) and a total absolute distance were not significantly closer to the ideal described anatomic centre.
conclusionsIntraoperative fluoroscopy was found effective as an aid for placing the femoral tunnel in a more accurate position, as compared to a desired anatomic centre. Although the concept of the "one-size-fits-all" approach for tunnel placement is debatable, the avoidance of grossly misplaced tunnels is the benefit of using fluoroscopy during ACL reconstruction. The authors hold that fluoroscopy is readily available, safe and easy to use and therefore a good aid in the anatomic approach for graft tunnel placement, for example, in a learning situation, in revision cases and when performing low volumes of such surgery. LEVEL OF EVIDENCE: III.
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