3D CT analysis of the positioning of the femoral tunnel using single-bundle reconstruction of the ACL by drill-ing through an additionally created low medial approach

Abstract

Introduction: We analyzed the location of the femoral bone tunnel by performing 3D CT reconstructions postoperatively after single-bundle reconstruction of the ACL using an additional low medial approach.

Materials and methods: The data of 34 patients was analyzed by 3D CT reconstruction, after single-bundle reconstruction of the ACL. Images were analyzed according to the method of Bernard (1997) regarding the position of the femoral bone tunnel.

Results: The mean distance from the center of the femoral tunnel to the posterior surface of the femoral condyle along the line parallel to the line of Blumensaat (t) was 37.4% ± 6%. The mean distance from the center of the femoral tunnel to the line of Blumensaat along a line perpendicular to the line of Blumensaat (h) is 27%± 3%. In the 4x4 grid, femoral tunnel centers were located—2 in the 2c box and 32 in the 2b box. The mean length of femoral tunnels was 30±0.5 mm.

Conclusion: Using the technique of making an additional low medial approach during single-bundle reconstruction of the ACL allows to make a femoral bone tunnel in an anatomic position, namely between the foot-prints of the AM and PL bundle of the ACL.