ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024
Evaluating femoral graft placement using three-dimensional magnetic resonance imaging in the reconstruction of the anterior cruciate ligament via independent or transtibial drilling techniques: a retrospective cohort study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. 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, 3 citations in OpenAlex.
- ACL reconstruction in football players: A nationwide Swedish registry study of anteromedial versus transtibial femoral tunnel techniques.Journal of experimental orthopaedics · 2026Article
- Comparison of autograft and allograft outcomes in adolescent ACL reconstruction: a propensity score analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
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6 authors at 2 institutions in 1 country.
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Abstract
purposeAnterior cruciate ligament (ACL) reconstruction is a common surgical procedure, yet failure still largely occurs due to nonanatomically positioned grafts. The purpose of this study was to retrospectively evaluate patients with torn ACLs before and after reconstruction via 3D MRI and thereby assess the accuracy of graft position on the femoral condyle.
methodsForty-one patients with unilateral ACL tears were recruited. Each patient underwent 3D MRI of both knees before and after surgery. The location of the reconstructed femoral footprint relative to the patient's native footprint was compared.
resultsNative ACL anatomical location of the native ACL had a significant impact on graft position. Native ACLs that were previously more anterior yielded grafts that were more posterior (3.70 ± 1.22 mm, P = 0.00018), and native ACL that were previously more proximal yielded grafts that were more distal (3.25 ± 1.09 mm, P = 0.0042). Surgeons using an independent drilling method positioned 76.2% posteriorly relative to the native location, with a mean 0.1 ± 2.8 mm proximal (P = 0.8362) and 1.8 ± 3.0 mm posterior (P = 0.0165). Surgeons using a transtibial method positioned 75% proximal relative to the native location, with a mean 2.2 ± 3.0 mm proximal (P = 0.0042) and 0.2 ± 2.6 mm posterior (P = 0.8007). These two techniques showed a significant difference in magnitude in the distal-proximal axis (P = 0.0332).
conclusionThe femoral footprint position differed between the native and reconstructed ACLs, suggesting that ACL reconstructions are not accurate. Rather, they are converging to a normative reference point that is neither anatomical nor isometric.
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