Impact of Femoral Tunnel Orientation on ACL Reconstruction
Author Information
Author(s): Stefano Zaffagnini, Danilo Bruni, Sandra Martelli, Naoaki Imakiire, Maurilio Marcacci, Alessandro Russo
Primary Institution: Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, Bologna, Italy
Hypothesis
The orientation of femoral tunnel could affect the final knee stability in double bundle ACL reconstruction.
Conclusion
Horizontal tunnel reconstruction provides better stability than vertical tunnel reconstruction in ACL surgeries.
Supporting Evidence
- The horizontal tunnel reconstruction showed a median antero-posterior displacement of 0.8 mm less than the vertical tunnel.
- Internal-external rotation in horizontal tunnel reconstruction was 5° less than in vertical tunnel reconstruction.
- Both reconstructions corrected instability due to ACL rupture in antero-posterior displacements and internal-external rotations.
Takeaway
This study looked at how the angle of the tunnel used in knee surgeries affects how stable the knee is afterward. It found that a more horizontal angle is better.
Methodology
The study used six cadaver knees to compare the effects of horizontal and vertical femoral tunnel orientations on knee stability through various kinematic tests.
Potential Biases
Potential biases due to the use of cadaver specimens and the lack of standard load application during tests.
Limitations
The study was limited by a small sample size and the use of cadaver specimens, which may not fully replicate in-vivo conditions.
Participant Demographics
Donors aged between 21 and 53 years old, including 2 females and 4 males.
Statistical Information
P-Value
0.035
Confidence Interval
99% CI: Sup 0.028, Inf 0.042
Statistical Significance
p = 0.035
Digital Object Identifier (DOI)
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