Evidence map›Paper›PMID 30707249›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

No correlation between femoral tunnel orientation and clinical outcome at long-term follow-up after non-anatomic anterior cruciate ligament reconstruction.

David Sundemo, Julia Mårtensson, Eric Hamrin Senorski, Eleonor Svantesson, Jüri Kartus, Ninni Sernert, Jón Karlsson, Kristian Samuelsson

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Article 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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

8 authors.

David SundemoDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. David.sundemo@outlook.com.ORCID http://orcid.org/0000-0002-5871-1636
Julia MårtenssonDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eric Hamrin SenorskiDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eleonor SvantessonDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Jüri KartusNU-Hospital Group, Trollhättan/Uddevalla, Sweden.
Ninni SernertNU-Hospital Group, Trollhättan/Uddevalla, Sweden.
Jón KarlssonDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Kristian SamuelssonDepartment of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to determine the influence of femoral tunnel orientation on long-term clinical outcome and osteoarthritis in patients undergoing ACL reconstruction and to test the reliability of the implemented radiographic measurement methods. It was hypothesized that a more horizontal femoral tunnel would correlate with superior clinical outcome.

methodsA cohort of 193 patients who underwent non-anatomic ACL reconstruction was examined. In this specific study, non-anatomic is defined by the surgeons' pursuit of optimal isometry, not to emulate the native ACL anatomy. At follow-up, the Lachman test, the KT-1000, the pivot-shift test, the one-leg-hop test and the IKDC-2000 were evaluated. Osteoarthritis was evaluated radiographically. Posteroanterior and lateral radiographs were used to determine the position of the femoral tunnel in the coronal and sagittal planes and the angle of the tunnel in the coronal plane. A method for determining femoral rotation on the lateral radiographs was developed and its reliability was evaluated. The femoral tunnel orientation was analyzed to examine its influence on clinical outcome and osteoarthritis.

resultsA total of 101 patients were analyzed at a mean of 16.4 (± 1.3) years postoperatively. The reliability of the measurement methods was regarded as good to excellent (ICC 0.57-0.97). The mean coronal femoral tunnel angle was 9.6° (± 9.4°). The coronal femoral tunnel was positioned at a mean of 43% (± 3.5%) of the distance measured from lateral to medial. The mean sagittal femoral tunnel position, measured using the quadrant method, was 40% (± 6.4%) from posterior to anterior. No significant associations were found between tunnel orientation and the clinical outcome variables.

conclusionsThe orientation of the femoral tunnel did not predict the long-term subjective outcome, functional outcome or the development of osteoarthritis in patients undergoing non-anatomic ACL reconstruction. The method for determining femoral rotation on lateral radiographs was found to be reliable. LEVEL OF EVIDENCE: Retrospective cohort study, level of evidence IV.

Indexed as

AdultAnterior Cruciate Ligament ReconstructionCohort StudiesFemaleFemurFollow-Up StudiesHumansMaleOsteoarthritisRadiographyRetrospective StudiesAnterior cruciate ligament reconstructionFemoral tunnel angleOsteoarthritisOutcomeQuadrant methodRadiographsSurgery

Identifiers

PMID30707249
PMCPMC6800880

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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.