ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Intraoperative fluoroscopy reduces the variability in femoral tunnel placement during single-bundle anterior cruciate ligament reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 14 citations in OpenAlex.
- 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
- Radiographic acceptable zone of endobutton placement in ACL reconstruction: A prospective study.Journal of experimental orthopaedics · 2024Article
- App-based analysis of the femoral tunnel position in ACL reconstruction using the quadrant method.Archives of orthopaedic and trauma surgery · 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
- Application of multiplanar reconstruction and 3D printing in anterior cruciate ligament revision.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Article
- The apex of the deep cartilage is a stable landmark to position the femoral tunnel during remnant-preserving anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Grid and Image Intensifier Improve Arthroscopic ACL Tunnel Position and Patient-Reported Outcomes.Arthroscopy, sports medicine, and rehabilitation · 2023Article
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7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the effect of using intraoperative fluoroscopy on femoral and tibial tunnel positioning variability in single-bundle anterior cruciate ligament (ACL) reconstruction.
methodsA total of 80 consecutive patients with single-bundle ACL reconstruction between 2014 and 2016 were retrospectively reviewed. Among them, 40 underwent ACL reconstruction without fluoroscopy (non-fluoroscopy group) and 40 underwent fluoroscopy-assisted ACL reconstruction (fluoroscopy group). Femoral and tibial tunnel locations were evaluated using a standardized grid system with three-dimensional computed tomography images. Femoral and tibial tunnel location variability was compared between the groups.
resultsThe operation time was longer in the fluoroscopy group than in the non-fluoroscopy group (61.3 ± 5.2 min vs. 55.5 ± 4.5 min, p < 0.001). In the fluoroscopy group, a guide pin was repositioned in 16 (40%) cases on the femoral side and 2 (5%) cases on the tibial side. No significant difference in the femoral tunnel location was observed between the fluoroscopy and non-fluoroscopy groups (anterior-posterior plane, 29.0% ± 3.2% vs. 30.0% ± 6.1%; proximal-distal plane, 30.8% ± 4.8% vs. 29.4% ± 8.3%; all parameters, n.s.); variability was significantly lower in the fluoroscopy group (p < 0.001 for both anterior-posterior and proximal-distal planes). No significant difference in the tibial tunnel location and variability was observed between the fluoroscopy and non-fluoroscopy groups (medial-lateral plane, 45.8% ± 2.0% vs. 46.6% ± 2.4%; anterior-posterior plane, 31.2% ± 4.0% vs. 31.0% ± 5.4%) (all parameters, n.s.).
conclusionsTunnel positioning with fluoroscopic assistance is feasible and effective in achieving consistency in femoral tunnel placement despite a slightly longer operation time. Intraoperative fluoroscopy can be helpful in cases wherein identifying anatomical landmarks on arthroscopy was difficult or for surgeons with less experience who performed ACL reconstruction. LEVEL OF EVIDENCE: IV.
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