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J Knee Surg 2022; 35(13): 1467-1473
DOI: 10.1055/s-0041-1726418
Original Article

Reconstruction of the Anterior Cruciate Ligament Using Ruler-Assisted Positioning of the Femoral Tunnel Relative to the Posterior Apex of the Deep Cartilage: A Single-Center Case Series

Yan Dong
1   Department of Orthopedics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
,
Jiaguang Tang
1   Department of Orthopedics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
,
Peng Cui
1   Department of Orthopedics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
,
Songpo Shen 
1   Department of Orthopedics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
,
Guodong Wang
1   Department of Orthopedics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
,
Jian Li
2   Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
,
Xiaochuan Kong
2   Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
,
Gang Hong
2   Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
,
Shuo Yuan
2   Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
,
Lei Zang
2   Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
› Author Affiliations Funding None.
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Abstract

The techniques available to locate the femoral tunnel during anterior cruciate ligament (ACL) reconstruction have notable limitations. To evaluate whether the femoral tunnel center could be located intraoperatively with a ruler, using the posterior apex of the deep cartilage (ADC) as a landmark. This retrospective case series included consecutive patients with ACL rupture who underwent arthroscopic single-bundle ACL reconstruction at the Department of Orthopedics, Beijing Tongren Hospital between January 2014 and May 2018. During surgery, the ADC of the femoral lateral condyle was used as a landmark to locate the femoral tunnel center with a ruler. Three-dimensional computed tomography (CT) was performed within 3 days after surgery to measure the femoral tunnel position by the quadrant method. Arthroscopy was performed 1 year after surgery to evaluate the intra-articular conditions. Lysholm and International Knee Documentation Committee (IKDC) scores were determined before and 1 year after surgery. The final analysis included 82 knees of 82 patients (age = 31.7 ± 6.1 years; 70 males). The femoral tunnel center was 26 ± 1.5% in the deep-shallow (x-axis) direction and 31 ± 3.1% in the high-low (y-axis) direction, close to the “ideal” values of 27 and 34%. Lysholm score increased significantly from 38.5 (33.5–47) before surgery to 89 (86–92) at 1 year after surgery (p < 0.001). IKDC score increased significantly from 42.5 (37–47) before surgery to 87 (83.75–90) after surgery (p < 0.001). Using the ADC as a landmark, the femoral tunnel position can be accurately selected using a ruler.

Keywords

anterior cruciate ligament - anatomic reconstruction - ruler - bone tunnel - secondary exploration


Publication History

Received: 10 September 2020

Accepted: 12 February 2021

Article published online:
14 April 2021

© 2021. Thieme. All rights reserved.

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