ArticleJournal of experimental orthopaedics2019
Anteversion and length of the femoral tunnel in ACL reconstruction: in-vivo comparison between rigid and flexible instrumentation.
Article in Journal of experimental orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Femoral tunnel length does not impact outcomes following ACL reconstruction using a single-bundle quadriceps tendon autograft: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Flexible reamers create comparable anterior cruciate ligament reconstruction femoral tunnels without the hyperflexion required with rigid reamers: 3D-CT analysis of tunnel morphology in a randomised clinical trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Trial
- Comparisons of the radiological and functional results of femoral tunnels created in Figure-4 and 110° flexion positions in arthroscopic anterior cruciate ligament reconstruction.Joint diseases and related surgery · 2026Article
- Flexible Versus Rigid Reaming Systems for Independent Femoral Tunnel Reaming During ACL Reconstruction: Minimum 2-Year Clinical Outcomes.Orthopaedic journal of sports medicine · 2022Article
- A prospective randomized study of arthroscopic ACL reconstruction with adjustable- versus fixed-loop device for femoral side fixation.Knee surgery & related research · 2021Article
- Comparing the Use of Flexible and Rigid Reaming Systems Through an Anteromedial Portal for Femoral Tunnel Creation During Anterior Cruciate Ligament Reconstruction: A Systematic Review.Orthopaedic journal of sports medicine · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDue to it being tangential to the distal femoral axis, the anteromedial portal presents significant risk of causing iatrogenic damage, and of producing tunnels that are too short for optimal osseointegration. Flexible reamers were developed to eliminate the need for knee hyperflexion and offer better-controlled orientation of the femoral tunnel. We aimed to compare the anteversion and length of femoral tunnels drilled using flexible reamers to those drilled using rigid reamers.
methodsBetween May 2012 and December 2013, all patients receiving ACL reconstruction performed by one surgeon were operated on using either a rigid or a flexible reamer from the same supplier (Versi-Tomic® system, Stryker, Kalamazoo, Michigan). The height of each patient was recorded, and the length and anteversion of the femoral tunnels were measured intra-operatively and on true lateral radiographs, respectively.
resultsThirty-seven patients underwent operations using the rigid instrumentation, and 43 using the flexible instrumentation. There was no statistically significant difference between the two groups in either sex or height (p = n.s.). The patients operated on using the rigid instrumentation had tunnels anteverted by 18.6° ± 6° and 33.6 ± 2.9 mm long. Those operated on using the flexible instrumentation had tunnels anteverted by 40° ± 2° and 41.1 ± 3.57 mm long. Both anteversion and tunnel length were significantly greater for tunnels drilled using the flexible instrumentation (p < 0.001).
conclusionsThis study demonstrated that flexible reamers produce significantly more anteverted and longer femoral tunnels during ACL reconstruction than rigid reamers. Clinical studies remain necessary to assess the outcomes of ACL reconstruction using flexible reamers.
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