Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study

Abstract Purpose To evaluate the possibility to access the anatomic femoral insertion of the anterior cruciate ligament (ACL) through trans‐tibial (TT) and trans‐portal technique, for ACL reconstruction in an independent way. To register anatomical characteristics of the TT tunnels. Methods Ten form...

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Main Authors: Daniel Acevedo Tobler, Santiago Hermosilla, Natalia Otero, Juan Kenny, Juan Del Castillo
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1186/s40634-021-00444-w
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author Daniel Acevedo Tobler
Santiago Hermosilla
Natalia Otero
Juan Kenny
Juan Del Castillo
author_facet Daniel Acevedo Tobler
Santiago Hermosilla
Natalia Otero
Juan Kenny
Juan Del Castillo
author_sort Daniel Acevedo Tobler
collection DOAJ
description Abstract Purpose To evaluate the possibility to access the anatomic femoral insertion of the anterior cruciate ligament (ACL) through trans‐tibial (TT) and trans‐portal technique, for ACL reconstruction in an independent way. To register anatomical characteristics of the TT tunnels. Methods Ten formaldehyde preserved knee anatomic articular specimens were dissected. Femoral tunnels were confectioned reproducing the original topography of the ACL. First, the femoral tunnel was made with the independent trans‐portal technique. Then, utilizing the tibial stump of the ACL and tibial guides at 45°, the TT tunnels were confectioned trying to match the previously made femoral tunnel by trans‐portal technique. Results In all specimens, match between the TT tunnel with the independent trans‐portal tunnel was achieved. Mean values for TT coronal angle was 53,0°, for transversal angle 43,3° and for distance from tunnel to joint line 2,55 cm. A horizontalization and medialization of the TT tunnels had to be made to adequately match with the femoral tunnel made by the independent trans‐portal technique. Conclusions By macroscopic anatomic and independent means, an anatomic femoral tunnel was confectioned with the TT technique matching with the anatomic femoral tunnel made in an independent way. As clinical relevance, the present study allows to anatomically assess the possibility to perform an anatomic femoral tunnel through the TT technique. Level of evidence V
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spelling doaj-art-b9e66931d00145ff8be8a3e9d35713eb2025-08-20T02:05:21ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-021-00444-wAnterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric studyDaniel Acevedo Tobler0Santiago Hermosilla1Natalia Otero2Juan Kenny3Juan Del Castillo4Cátedra de Traumatología y OrtopediaUniversidad de MontevideoMontevideoUruguayDepartamento de AnatomíaFacultad de Medicina Universidad de la RepúblicaMontevideoUruguayCátedra de Traumatología y OrtopediaUniversidad de MontevideoMontevideoUruguayDepartamento de AnatomíaFacultad de Medicina Universidad de la RepúblicaMontevideoUruguayDepartamento de AnatomíaFacultad de Medicina Universidad de la RepúblicaMontevideoUruguayAbstract Purpose To evaluate the possibility to access the anatomic femoral insertion of the anterior cruciate ligament (ACL) through trans‐tibial (TT) and trans‐portal technique, for ACL reconstruction in an independent way. To register anatomical characteristics of the TT tunnels. Methods Ten formaldehyde preserved knee anatomic articular specimens were dissected. Femoral tunnels were confectioned reproducing the original topography of the ACL. First, the femoral tunnel was made with the independent trans‐portal technique. Then, utilizing the tibial stump of the ACL and tibial guides at 45°, the TT tunnels were confectioned trying to match the previously made femoral tunnel by trans‐portal technique. Results In all specimens, match between the TT tunnel with the independent trans‐portal tunnel was achieved. Mean values for TT coronal angle was 53,0°, for transversal angle 43,3° and for distance from tunnel to joint line 2,55 cm. A horizontalization and medialization of the TT tunnels had to be made to adequately match with the femoral tunnel made by the independent trans‐portal technique. Conclusions By macroscopic anatomic and independent means, an anatomic femoral tunnel was confectioned with the TT technique matching with the anatomic femoral tunnel made in an independent way. As clinical relevance, the present study allows to anatomically assess the possibility to perform an anatomic femoral tunnel through the TT technique. Level of evidence Vhttps://doi.org/10.1186/s40634-021-00444-wAnterior cruciate ligamentReconstructionTrans‐tibial tunnelFemoral tunnel
spellingShingle Daniel Acevedo Tobler
Santiago Hermosilla
Natalia Otero
Juan Kenny
Juan Del Castillo
Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
Journal of Experimental Orthopaedics
Anterior cruciate ligament
Reconstruction
Trans‐tibial tunnel
Femoral tunnel
title Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
title_full Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
title_fullStr Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
title_full_unstemmed Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
title_short Anterior cruciate ligament reconstruction, can an anatomic femoral tunnel be achieved with the trans‐tibial technique? Cadaveric study
title_sort anterior cruciate ligament reconstruction can an anatomic femoral tunnel be achieved with the trans tibial technique cadaveric study
topic Anterior cruciate ligament
Reconstruction
Trans‐tibial tunnel
Femoral tunnel
url https://doi.org/10.1186/s40634-021-00444-w
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