ArticleOrthopaedic journal of sports medicine2021
Tibial Tunnel Placement in ACL Reconstruction Using a Novel Grid and Biplanar Stereoradiographic Imaging.
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 2 papers.
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2 citing papers in PubMed, 2 citations in OpenAlex.
- Steep tibial slope correlates with inferior patient‑reported knee function independent of tunnel widening.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- The effect of 30° and 70° arthroscope use on femoral and tibial tunnel placement in arthroscopic anterior cruciate ligament reconstruction surgery.Revista da Associacao Medica Brasileira (1992) · 2026Article
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Authors and funding
5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNonanatomic graft placement is a frequent cause of anterior cruciate ligament reconstruction (ACLR) failure, and it can be attributed to either tibial or femoral tunnel malposition. To describe tibial tunnel placement in ACLR, we used EOS, a low-dose biplanar stereoradiographic imaging modality, to create a comprehensive grid that combines anteroposterior (AP) and mediolateral (ML) coordinates. PURPOSE: To (1) validate the automated grid generated from EOS imaging and (2) compare the results with optimal tibial tunnel placement. STUDY
designDescriptive laboratory study.
methodsUsing EOS, 3-dimensional models were created of the knees of 37 patients who had undergone ACLR. From the most medial, lateral, anterior, and posterior points on the tibial plateau of the EOS 3-dimensional model for each patient, an automated and personalized grid was generated from 2 independent observers' series of reconstructions. To validate this grid, each observer also manually measured the ML and AP distances, the medial proximal tibial angle (MPTA), and the tibial slope for each patient. The ideal tibial tunnel placement, as described in the literature, was compared with the actual tibial tunnel grid coordinates of each patient.
resultsThe automated grid metrics for observer 1 gave a mean (95% CI) AP depth of 54.7 mm (53.4-55.9), ML width of 75.0 mm (73.3-76.6), MPTA of 84.9° (83.7-86.0), and slope of 7.2° (5.4-9.0). The differences with corresponding manual measurements were means (95% CIs) of 2.4 mm (1.4-3.4 mm), 0.5 mm (-1.3 to 2.2 mm), 1.2° (-0.4° to 2.9°), and -0.4° (-2.1° to 1.2°), respectively. The correlation between automated and manual measurements was
conclusionThe automated grid created using biplanar stereoradiographic imaging provided a novel, precise, and reproducible description of the tibial tunnel placement in ACLR. CLINICAL RELEVANCE: This technique can be used during preoperative planning, intraoperative guidance, and postoperative evaluation of tibial tunnel placement in ACLR.
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