Keywords : Tunnel position
Study of femoral and tibial tunnel position using CT scan, and its effect on functional outcome in arthroscopic ACL reconstruction: A prospective study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 106-113
Background: Accurate placement of tibial and femoral tunnel has significant effect on
functional outcome after anterior cruciate ligament reconstruction (ACLR). Anterior cruciate
ligament tear is one of the common sports injuries, and arthroscopic reconstruction is now a
day’s popular surgery. Its failure is rare but not uncommon. Despite advances, failure rate
after ACL reconstruction (ACLR), ranges from 0.7% to 10%1. Slight anterior placement of
femoral tunnel can lead to restriction of knee flexion and, similarly if tibial tunnel is anterior,
it leads to impingement of graft, surgical failure and also the need for a revision surgery.
Post-operative CT scan provide a reliable and valid way for the assessment of anatomical
tunnel position and obliquity after ACLR.
Materials and Methods: 31 patients with complete ACL tear with or without the meniscal
injury are treated with single bundle arthroscopic reconstruction using hamstring graft tendon.
With common post-operative rehabilitation protocol all patient are followed up clinically and
radiological for next 2 year. Femoral, tibial tunnel positions on sagittal plane. Were measured
interpreted with the clinical parameters. Radiological parameters were summarized as mean
standard deviation and proportions as applicable.
Results: Total no of patients with the age averaged 27.13± 5.89, pre op lysholm score
averaged 64.26±8.93. At 24 months follow up position of the tibial tunnel was found to be at
an average of 31.55%±4.79posterior from the anterior edge of the tibia. The femoral tunnel
was found at an average of 28.54±3.18% anterior to the posterior femoral cortex. 32.2% and
35.5% of patients showed grade 1 anterior drawer and lachman test positive respectively. And
mean lysholm score averaged to be 86.58±5.32.
Conclusion: The location of femoral tunnel in the mid sagittal section from the posterior
cortex 28.54±3.18% of anteroposterior length showed no significant correlation the lysholm
scoring. Locating the tibial tunnel positioning on the tibial plateau from the anterior cortex of
Showed significant p value with functional outcome.