ArticleJournal of orthopaedic case reports2026
CT-Based Tunnel Position Analysis and its Correlation with Residual Instability after Anterior Cruciate Ligament Reconstruction.
Article in Journal of orthopaedic case reports, 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
Introduction: Anterior cruciate ligament (ACL) reconstruction aims to restore knee stability, but improper femoral and tibial tunnel placement can lead to persistent instability. Computed tomography (CT)-based 3D assessment helps correlate tunnel position with outcomes. Materials and Methods: A study of 50 patients undergoing primary arthroscopic ACL reconstruction used post-operative CT to assess tunnel placement relative to anatomical landmarks. Knee stability was evaluated using Lachman and pivot shift tests, and patients were grouped by residual instability. Results: Residual instability occurred in 36% of patients. Anatomical femoral and tibial tunnel placement was achieved in 62% and 68% of cases, respectively. Non-anatomical femoral (66.7%) and tibial (55.6%) tunnels were more common in unstable knees, with combined malposition showing the highest instability rates. Conclusion: Non-anatomical tunnel placement, especially femoral, is strongly associated with residual instability, emphasizing the importance of precise anatomical positioning in ACL reconstruction.
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