ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
Increased revision rate with posterior tibial tunnel placement after using the 70-degree tibial guide in 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 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Failure modes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis.International orthopaedics · 2023Pooled it
- Trauma and femoral tunnel position are the most common failure modes of anterior cruciate ligament reconstruction: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Pooled it
- Anterior cruciate ligament foot plate anatomy: 3-dimensional and 2-dimensional MRI evaluation with arthroscopy assessment in a subset of patients.European radiology · 2022Article
- Etiology of Failed Anterior Cruciate Ligament Reconstruction: a Scoping Review.Current reviews in musculoskeletal medicine · 2022Article
- The risk of graft impingement still exists in modern ACL surgery and correlates with degenerative MRI signal changes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Anterior root of lateral meniscus and medial tibial spine are reliable intraoperative landmarks for the tibial footprint of anterior cruciate ligament.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Failed Meniscal Repairs After Anterior Cruciate Ligament Reconstruction Increases Risk of Revision Surgery.Orthopaedic journal of sports medicine · 2020Article
- Anatomic femoral tunnel placement is difficult by the transtibial technique: comparison of three different femoral tunnel drilling techniques in double-bundle anterior cruciate ligament reconstructions.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- An In Vivo Prediction of Anisometry and Strain in Anterior Cruciate Ligament Reconstruction - A Combined Magnetic Resonance and Dual Fluoroscopic Imaging Analysis.Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2018Article
- Management of Anterior Cruciate Ligament Injury: What's In and What's Out?Indian journal of orthopaedicsArticle
- Radiographic assessment of the tibiofemoral relationship in anterior cruciate ligament deficient knees.Journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo map knee morphology radiographically in a population with a torn ACL and to investigate whether anatomic factors could be related to outcomes after ACL reconstruction at mid- to long-term follow-up. Further, we wanted to assess tibial tunnel placement after using the 70-degree "anti-impingement" tibial tunnel guide and investigate any relation between tunnel placement and revision surgery.
methodsPatients undergoing ACL reconstruction involving the 70-degree tibial guide from 2003 to 2008 were included. Two independent investigators analysed pre- and post-operative radiographs. Demographic data and information on revision surgery were collected from an internal database. Anatomic factors and post-operative tibial tunnel placements were investigated as predictors of revision.
resultsThree-hundred and seventy-seven patients were included in the study. A large anatomic variation with significant differences between men and women was seen. None of the anatomic factors could be related to a significant increase in revision rate. Patients with a posterior tibial tunnel placement, defined as 50 % or more posterior on the Amis and Jakob line, did, however, have a higher risk of revision surgery compared to patients with an anterior tunnel placement (P = 0.03).
conclusionUse of the 70-degree tibial guide did result in a high incidence (47 %) of posterior tibial tunnel placements associated with an increased rate of revision surgery. The current study was, however, not able to identify any anatomic variation that could be related to a higher risk of revision surgery. Avoiding graft impingement from the femoral roof in anterior tibial tunnel placements is important, but the insight that overly posterior tunnel placement can lead to inferior outcome should also be kept in mind when performing ACL surgery. LEVEL OF EVIDENCE: IV.
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