Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction

Introduction: Anterior cruciate ligament (ACL) tears are a common musculoskeletal injury often requiring anterior cruciate ligament reconstruction (ACLR). Many factors are thought to influence patient outcome and determining the extent can allow for optimisation of patient care. One of these factors...

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Main Authors: Rogger M, Al-Dadah O
Format: Article
Language:English
Published: Malaysian Orthopaedic Association 2025-07-01
Series:Malaysian Orthopaedic Journal
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Online Access:https://www.morthoj.org/2025/v19n2/graft-tunnel-placement.pdf
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author Rogger M
Al-Dadah O
author_facet Rogger M
Al-Dadah O
author_sort Rogger M
collection DOAJ
description Introduction: Anterior cruciate ligament (ACL) tears are a common musculoskeletal injury often requiring anterior cruciate ligament reconstruction (ACLR). Many factors are thought to influence patient outcome and determining the extent can allow for optimisation of patient care. One of these factors is graft tunnel placement, both femoral and tibial. The aim of this study was to investigate whether graft tunnel placement influences clinical outcome following ACLR. Materials and methods: The patient responses from six patient-reported outcome measures (PROM) at initial presentation and one year following ACLR, as well as demographic data at presentation, were collected. Graft tunnel placement was evaluated using 10 validated radiological measurements on antero-posterior and lateral radiographs following surgery. Results: A total of 45 patients were included in the study. There was a significant longitudinal improvement (p<0.001) for almost all PROM scores when comparing pre-operative to post-operative results. Overall, no significant correlation was demonstrated between graft tunnel placement and PROM scores, except for a weak association between femoral tunnel positioning on lateral view radiographs and the overall Knee injury and Osteoarthritis Outcome Score (rho=0.37, p=0.038) and the Lysholm score (rho=0.36, p=0.034) and also tibial tunnel placement on lateral view radiographs and the EQ-5D VAS score (rho=0.37, p=0.037). Conclusion: ACLR is a clinically successful treatment strategy for patients with symptomatic ACL tears. Graft tunnel positioning does not generally affect clinical outcomes, although there may be a weak association with femoral tunnel positioning on lateral radiographs.
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spelling doaj-art-c480f575ed804810a5f97398bf4b2bb52025-08-20T04:00:44ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2025-07-0119211010.5704/MOJ.2507.006Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament ReconstructionRogger M0Al-Dadah O1Department of Trauma and Orthopaedics, South Tyneside District Hospital, South Shields, United KingdomDepartment of Trauma and Orthopaedics, South Tyneside District Hospital, South Shields, United Kingdom; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, United KingdomIntroduction: Anterior cruciate ligament (ACL) tears are a common musculoskeletal injury often requiring anterior cruciate ligament reconstruction (ACLR). Many factors are thought to influence patient outcome and determining the extent can allow for optimisation of patient care. One of these factors is graft tunnel placement, both femoral and tibial. The aim of this study was to investigate whether graft tunnel placement influences clinical outcome following ACLR. Materials and methods: The patient responses from six patient-reported outcome measures (PROM) at initial presentation and one year following ACLR, as well as demographic data at presentation, were collected. Graft tunnel placement was evaluated using 10 validated radiological measurements on antero-posterior and lateral radiographs following surgery. Results: A total of 45 patients were included in the study. There was a significant longitudinal improvement (p<0.001) for almost all PROM scores when comparing pre-operative to post-operative results. Overall, no significant correlation was demonstrated between graft tunnel placement and PROM scores, except for a weak association between femoral tunnel positioning on lateral view radiographs and the overall Knee injury and Osteoarthritis Outcome Score (rho=0.37, p=0.038) and the Lysholm score (rho=0.36, p=0.034) and also tibial tunnel placement on lateral view radiographs and the EQ-5D VAS score (rho=0.37, p=0.037). Conclusion: ACLR is a clinically successful treatment strategy for patients with symptomatic ACL tears. Graft tunnel positioning does not generally affect clinical outcomes, although there may be a weak association with femoral tunnel positioning on lateral radiographs. https://www.morthoj.org/2025/v19n2/graft-tunnel-placement.pdfanterior cruciate ligamentpatient-reported outcome measuresgraft tunnel placementreconstructionradiograph
spellingShingle Rogger M
Al-Dadah O
Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
Malaysian Orthopaedic Journal
anterior cruciate ligament
patient-reported outcome measures
graft tunnel placement
reconstruction
radiograph
title Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
title_full Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
title_fullStr Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
title_full_unstemmed Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
title_short Impact of Graft Tunnel Placement on Short-Term Clinical Outcome Following Anterior Cruciate Ligament Reconstruction
title_sort impact of graft tunnel placement on short term clinical outcome following anterior cruciate ligament reconstruction
topic anterior cruciate ligament
patient-reported outcome measures
graft tunnel placement
reconstruction
radiograph
url https://www.morthoj.org/2025/v19n2/graft-tunnel-placement.pdf
work_keys_str_mv AT roggerm impactofgrafttunnelplacementonshorttermclinicaloutcomefollowinganteriorcruciateligamentreconstruction
AT aldadaho impactofgrafttunnelplacementonshorttermclinicaloutcomefollowinganteriorcruciateligamentreconstruction