ArticleRevista da Associacao Medica Brasileira (1992)2026
The effect of 30° and 70° arthroscope use on femoral and tibial tunnel placement in arthroscopic anterior cruciate ligament reconstruction surgery.
Article in Revista da Associacao Medica Brasileira (1992), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe success of anterior cruciate ligament reconstruction depends on anatomical tunnel placement. The aim of this was to compare the effects of 30° and 70° arthroscopes on femoral and tibial tunnel positioning and their relationship with clinical outcomes.
methodsThis retrospective study analyzed 55 patients who underwent anterior cruciate ligament reconstruction between 2020 and 2024 (30° arthroscope, n=28; 70° arthroscope, n=27). All procedures were performed by the same surgeon using hamstring tendon grafts with suspensory femoral fixation and bioabsorbable tibial screws. Femoral and tibial tunnel positions were evaluated on postoperative computed tomography using the Bernard-Hertel and Staubli-Rauschning methods, respectively, with measurements performed by four orthopedic surgeons; clinical outcomes were assessed at ≥6 months using the International Knee Documentation Committee score.
resultsFemoral tunnels were significantly more posterior and distal in the 70° group (depth 29.4 vs. 38.7%; height 33.7 vs. 43.1%; both p<0.001). Tibial tunnel placement showed no significant difference (p=0.49). International Knee Documentation Committee scores were higher in the 70° group (89.2±5.4 vs. 84.6±6.8; p=0.02). Correlation and regression analyses confirmed femoral tunnel position as an independent predictor of functional outcome. Receiver operating characteristic curve analysis showed area under the curve values of 0.75 (95%CI 0.69-0.79) for depth and 0.71 (95%CI 0.67-0.78) for height.
conclusionUse of a 70° arthroscope in anterior cruciate ligament reconstruction enables more anatomical femoral tunnel placement and improves functional outcomes, while tibial tunnel positioning is unaffected. Arthroscopic viewing angle should be regarded not only as a technical factor but also as a determinant of clinical success.
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