Evidence map›Paper›PMID 30406406›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Tunnel placement in ACL reconstruction surgery: smaller inter-tunnel angles and higher peak forces at the femoral tunnel using anteromedial portal femoral drilling-a 3D and finite element analysis.

Thomas Tampere, Wouter Devriendt, Michiel Cromheecke, Thomas Luyckx, Matthias Verstraete, Jan Victor

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  12. [Finite element analysis of the graft stresses after anterior cruciate ligament reconstruction].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Thomas TampereDepartment of Orthopaedic Surgery, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. ttampere@gmail.com.ORCID http://orcid.org/0000-0001-6033-5943
Wouter DevriendtDepartment of Orthopaedic Surgery, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
Michiel CromheeckeDepartment of Orthopaedic Surgery, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
Thomas LuyckxDepartment of Orthopaedic Surgery, AZ Delta, Brugsesteenweg 90, 8800, Roeselare, Belgium.
Matthias VerstraeteDepartment of Orthopaedic Surgery, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
Jan VictorDepartment of Orthopaedic Surgery, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecent studies have emphasized the importance of anatomical ACL reconstruction to restore normal knee kinematics and stability. Aim of this study is to evaluate and compare the ability of the anteromedial (AM) and transtibial (TT) techniques for ACL reconstruction to achieve anatomical placement of the femoral and tibial tunnel within the native ACL footprint and to determine forces within the graft during functional motion. As the AM technique is nowadays the technique of choice, the hypothesis is that there are significant differences in tunnel features, reaction forces and/or moments within the graft when compared to the TT technique.

methodsTwenty ACL-deficient patients were allocated to reconstruction surgery with one of both techniques. Postoperatively, all patients underwent a computed tomography scan (CT) allowing 3D reconstruction to analyze tunnel geometry and tunnel placement within the native ACL footprint. A patient-specific finite element analysis (FEA) was conducted to determine reaction forces and moments within the graft during antero-posterior translation and pivot-shift motion.

resultsWith significantly shorter femoral tunnels (p < 0.001) and a smaller inter-tunnel angle (p < 0.001), the AM technique places tunnels with less variance, close to the anatomical centre of the ACL footprints when compared to the TT technique. Using the latter, tibial tunnels were more medialised (p = 0.007) with a higher position of the femoral tunnels (p = 0.02). FEA showed the occurrence of higher, but non-significant, reaction forces in the graft, especially on the femoral side and lower, however, statistically not significant, reaction moments using the AM technique.

conclusionThis study indicates important, technique-dependent differences in tunnel features with changes in reaction forces and moments within the graft. LEVEL OF EVIDENCE: II.

Indexed as

AdultAnterior Cruciate LigamentAnterior Cruciate Ligament ReconstructionBiomechanical PhenomenaFemaleFemurFinite Element AnalysisHumansKnee JointMaleMotionPostoperative PeriodTibiaYoung Adult3DAnterior cruciate ligamentAnteromedialFEAFootprintReconstructionTranstibial

Identifiers

PMID30406406

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.