ArticleQuantitative imaging in medicine and surgery2023
The optimal tibial tunnel placement to maximize the graft bending angle in the transtibial posterior cruciate ligament reconstruction: a quantitative assessment in three-dimensional computed tomography model.
Article in Quantitative imaging in medicine and surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- [Research progress of tibial tunnel positioning techniques in posterior cruciate ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- What Is the Optimal Position of Low Tibial Tunnel in Transtibial Posterior Cruciate Ligament Reconstruction? A Quantitative Analysis Based on 2D CT Images and 3D Knee Models.Orthopaedic surgery · 2025Article
- Robot-assisted arthroscopic all-epiphyseal PCLR with remnant preservation in a 13-year-old boy: a case report and review of the literature.Frontiers in surgery · 2025Article
- An in-vitro three-dimensional surgical simulation technique to predict tibial tunnel length in transtibial posterior cruciate ligament reconstruction.Biomedical engineering online · 2024Article
- Decade-long insights into AI for orthopedic rehabilitation mapping research networks and future trajectories.Digital healthArticle
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10 authors.
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Abstract
Background: The graft bending angle created by the graft and the tibial tunnel has inevitably occurred during the transtibial posterior cruciate ligament (PCL) reconstruction. However, few studies quantitively analyzed this angle. This study aimed to (I) explore the optimal tibial tunnel placement to maximize the graft bending angle in the PCL reconstruction; (II) reveal the effect of the tibial tunnel placement on the graft bending angle. Methods: This was an in-vitro surgical simulation study based on the three-dimensional (3D) computed tomography (CT). A total of 55 patients who took CT scanning for knee injuries were selected (April 2020 to January 2022) from the local hospital database for review. The 3D knee models were established on the Mimics software based on the knees' CT data. Using the Rhinoceros software to simulate the transtibial PCL reconstruction on the 3D CT knee model. The anteromedial and anterolateral tibial tunnel approaches were simulated with different tibial tunnel angle. The graft bending angle and tibial tunnel length (TTL) with different tibial tunnel angles were quantitively analyzed. Results: The graft bending angle in anterolateral approach with a 50° tibial tunnel angle was significantly greater than it in anteromedial approach with a 60° tibial tunnel angle (P<0.001). There was no difference of the graft bending angle between the anterolateral approach with a 40° tibial tunnel angle and the anteromedial approach with a 60° tibial tunnel angle (P>0.05). The graft bending angle showed a strong correlation with the tibial tunnel angle (for anteromedial approach: r=0.759, P<0.001; for anterolateral approach: r=0.702, P<0.001). The best-fit equation to calculate the graft bending angle based on the tibial tunnel angle was Y = 0.89*X + 59.05 in anteromedial tibial tunnel approach (r Conclusions: The graft bending angle and TTL will significantly increase as the tibial tunnel angle becomes greater. Maximizing the tibial tunnel angle (50° tibial tunnel angle) in the anterolateral approach could provide the greatest graft bending angle in the PCL reconstruction. No matter how the tibial tunnel angle is changed in the anteromedial approach, using anterolateral approach might reduce the killer turn effect more effectively than using anteromedial approach.
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