TITLE:
Femoral Tunnels in Anatomical ACL Reconstruction: Techniques Inside Out X Outside In
AUTHORS:
Alexandre Pagotto Pacheco, Luiz Guilherme Hartmann, Roberto Freire da Mota e Albuquerque, Oswaldo Taglietta Filho
KEYWORDS:
ACL Reconstruction, Knee, ACL Surgery
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.8 No.10,
October
12,
2018
ABSTRACT: Objective: To
observe the accuracy and the advantages and disadvantages of the femoral
tunnels made by the two techniques. Materials and Methods: We randomly summoned
nineteen patients undergoing anatomic ACL reconstruction in a single band
technique by the same surgeon: Ten by group II (GII) and nine by Group I (GI). GI: drilling in the technical in-out.
GII: drilling the technique out-in. The patients underwent a CT scan with three-dimensional
reconstruction of the distal femur. Was applied the technique of quadrants
described by Bernard and Hertel and optimized for position by Forsythe and
observed in the femoral tunnel: the accuracy of the joint entry; posterior
cortical thickness in that point; emergency lateral distance to the lateral
epicondyle and the overall length. Results: The coordinates of the distances
obtained average was very close, with no statistical difference comparable to
that obtained by Bernard and Hertel and Forsythe. The distance from the tunnel
exit to the lateral epicondyle obtained average 1.46 cm in GI and 0.47 cm in
GII, with a significant statistical difference. The thickness of the posterior
cortex was 3.9 mm in GI and 5.4 mm in GII, with no statistical difference. The
length averaged was 3.07 cm in GI and GII in 2.94 cm, with no statistical
difference. Conclusions: Both techniques allow well placed tunnels, with no
statistical difference. In the technique in-out the tunnel exit is closer to
the lateral epicondyle. The thickness of the posterior cortex is similar. The
length of the femoral tunnel is similar and around 3 cm.