ArticleArthroscopy, sports medicine, and rehabilitation2022
A Modified Anatomic Transtibial Double-Bundle Anterior Cruciate Ligament Reconstruction Provides Reliable Bone Tunnel Positioning.
Article in Arthroscopy, sports medicine, and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Comparison of patellar tendon and hamstring grafts in ACL reconstruction: patellar tendon shows lower re-rupture rates in high-risk groups and comparable patient-reported outcomes in lower-risk patients.Archives of orthopaedic and trauma surgery · 2026Article
- Quantitative Evaluation of Transtibial Aiming Accuracy in Anterior Cruciate Ligament Reconstruction.Cureus · 2025Article
- No Difference in 10- to 14-Year Outcomes After Modified Transtibial Versus Anteromedial Portal Techniques in Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Age under 20 years, pre-operative participation in pivoting sports, and steep posterior tibial slope of more than 12° are risk factors for graft failure after double-bundle anterior cruciate ligament reconstruction.Journal of experimental orthopaedics · 2024Article
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Authors and funding
5 authors.
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Abstract
Purpose: To evaluate the femoral and tibial tunnel positions via a modified anatomic transtibial double-bundle anterior cruciate ligament (ACL) reconstruction. Methods: Patients who underwent double-bundle ACL reconstruction using the transtibial tunnel creation technique were identified. Double-bundle ACL reconstruction was performed for 94 knees using the transtibial tunnel creation technique. Tunnel aperture configurations and center positions of the anteromedial (AM) and posterolateral (PL) tunnels via postoperative 3-dimensional computed tomography were evaluated. Results: There were 94 knees included. Regarding the intra-articular tunnel aperture configurations, the AM and PL tunnels overlapped at the femoral and tibial aperture in 66.0% and 94.7% cases, respectively. The mean femoral bone tunnel center was located at 23.0 ± 3.9% in the posterior-to-anterior ratio and 28.7 ± 6.0% in the proximal-to-distal ratio for the AM tunnels and at 32.8 ± 4.7% and 51.2 ± 5.2% for the PL tunnels, respectively. In the tibial tunnels, the mean AM tunnel center was located at 31.4 ± 3.6% in the anterior-to-posterior ratio and 44.3 ± 1.8% in the medial-to-lateral ratio and at 47.5 ± 3.8% and 44.3 ± 1.9% in the PL tunnel center, respectively. The femoral tunnels of outliers, both those created in nonanatomic positions as well as the posterior wall blowouts, were revealed in 7.4% cases. The nonanatomical bone tunnel group had significant heavier weight patients, lower tibial posterior slope, and were anterior in the AM and PL tunnel position. Posterior wall blowouts were related to posterior and proximal PL bone tunnel positions. Conclusions: Modified transtibial double-bundle ACL reconstruction is a reliable tunnel creation technique with anatomic placement in 92.6% of the cases. The modification required that partially superimposing configuration of the 2 tibial tunnel apertures. The nonanatomic tunnels were related to patients of heavier weight and lower tibial posterior sloped knees, whereas the posterior wall blowouts were related to the posterior and proximal PL bone tunnel positions. Level of Evidence: Level IV, therapeutic case series.
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