ArticleOrthopaedic journal of sports medicine2021
Creating a Femoral Tunnel Aperture at the Anteromedial Footprint Versus the Central Footprint in ACL Reconstruction: Comparison of Contact Stress Patterns.
Article in Orthopaedic journal of sports medicine, 2021. 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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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Anteromedial Femoral Tunnel Placement Reduces Graft Failure Risk Without Affecting Rotational Stability in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review.Arthroscopy, sports medicine, and rehabilitation · 2026Review
- Sequential Workflow for Integrated Biological Repair in Combined Four-Graft Knee Reconstruction.SICOT-J · 2026Article
- The posterior femoral cartilage can be used as an anatomical reference for the creation of the femoral tunnel in anterior cruciate ligament reconstruction.Journal of experimental orthopaedics · 2025Article
- Superior reproducibility and femoral tunnel angulation with hybrid transtibial vs. anteromedial portal techniques in ACL reconstruction: a retrospective case-control study.Frontiers in surgery · 2025Article
- Finite element graft stress for anteromedial portal, transtibial, and hybrid transtibial femoral drillings under anterior translation and medial rotation: an exploratory study.Scientific reports · 2024Article
- The proximal posterior cartilage of the lateral femoral condyle can be used as a reference for positioning the femoral tunnel in ACL reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Review
- Effects of modified trans-tibial versus trans-portal technique on stress patterns around the femoral tunnel in anatomical single-bundle ACL reconstruction with different knee flexion angles using finite element analysis.BMC musculoskeletal disorders · 2022Article
- Reliable Anatomic Femoral Tunnel Positioning for Anterior Cruciate Ligament Reconstruction Using a Novel Femoral Aiming Guide.Video journal of sports medicineArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt remains unclear whether an anteromedial (AM) footprint or a central footprint anterior cruciate ligament (ACL) graft exhibits less contact stress with the femoral tunnel aperture. This contact stress can generate graft attrition forces, which can lead to potential graft failure. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the difference in contact stress patterns of the graft around a femoral tunnel that is created at the anatomic AM footprint versus the central footprint. It was hypothesized that the difference in femoral tunnel positions would influence the contact stress at the interface between the reconstructed graft and the femoral tunnel orifice. STUDY
designControlled laboratory study.
methodsA total of 24 patients who underwent anatomic single-bundle ACL reconstruction were included in this study. In 12 patients, the femoral tunnels were created at the center of the native AM footprint (AM group), and in the remaining 12 patients the center of the femoral tunnel was placed in the anatomic central footprint (central group). Three-dimensional knee models were created and manipulated using several modeling programs, and the graft-tunnel angle (GTA) was determined using a special software program. The peak contact stresses generated on the virtual ACL graft around the femoral tunnel orifice were calculated using a finite element method.
resultsThe mean GTA was significantly more obtuse in the AM group than in the central group (124.2° ± 5.9° vs 112.6° ± 7.9°;
conclusionCompared with the AM footprint ACL graft, the central footprint ACL graft developed significantly higher contact stress in the extended position, especially around the anterior aspect of the femoral tunnel orifice. CLINICAL RELEVANCE: The contact stress of the ACL graft at the extended position of the knee may be minimized by creating the femoral tunnel at the AM-oriented footprint.
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