More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears
Abstract Purpose The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL‐R) and postoperative meniscus tears. Methods This was a single institution, case–control study of 170 patients status‐post ACL‐R (2010–2019) separated into two matched gr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-023-00630-y |
| _version_ | 1797270752137838592 |
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| author | Jonathan D. Hughes Alexandra S. Gabrielli Jonathan F. Dalton Benjamin T. Raines Daniel Dewald Volker Musahl Bryson P. Lesniak |
| author_facet | Jonathan D. Hughes Alexandra S. Gabrielli Jonathan F. Dalton Benjamin T. Raines Daniel Dewald Volker Musahl Bryson P. Lesniak |
| author_sort | Jonathan D. Hughes |
| collection | DOAJ |
| description | Abstract Purpose The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL‐R) and postoperative meniscus tears. Methods This was a single institution, case–control study of 170 patients status‐post ACL‐R (2010–2019) separated into two matched groups (sex, age, BMI, graft type). Group 1—symptomatic, operative meniscus tears (both de novo and recurrent) after ACL‐R. Group 2—no postoperative meniscus tears. Femoral and tibial tunnel positions were measured by 2 authors via lateral knee radiographs that were used to measure two ratios (a/t and b/h). Ratio a/t was defined as distance from the tunnel center to dorsal most subchondral contour of the lateral femoral condyle (a) divided by total sagittal diameter of the lateral condyle along Blumensaat’s line (t). The ratio b/h was defined as distance between the tunnel and Blumensaat’s line (b) divided by maximum intercondylar notch height (h). Wilcoxon sign‐ranks paired test was used to compare measurements between groups (alpha set at p < 0.05). Results Group 1 had average follow up of 45 months and Group 2 had average follow up of 22 months. There were no significant demographic differences between Groups 1 and 2. Group 1—a/t was 32.0% (± 10.2), which was significantly more anterior than group 2, 29.3% (± 7.3; p < 0.05). There was no difference in average femoral tunnel ratio b/h or tibial tunnel placement between groups. Conclusions A relationship exists between more anterior/less anatomic femoral tunnel position and the presence of recurrent or de novo, operative meniscus tears after ACL‐R. Surgeons performing ACL‐R should strive for recreation of native anatomy via proper tunnel placement to maximize postoperative outcomes. Level of evidence Level III. |
| first_indexed | 2024-03-08T04:57:14Z |
| format | Article |
| id | doaj.art-2feb47dcb560416098a9af9c87ef85c4 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-25T02:09:15Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-2feb47dcb560416098a9af9c87ef85c42024-03-07T12:46:41ZengWileyJournal of Experimental Orthopaedics2197-11532023-01-01101n/an/a10.1186/s40634-023-00630-yMore anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tearsJonathan D. Hughes0Alexandra S. Gabrielli1Jonathan F. Dalton2Benjamin T. Raines3Daniel Dewald4Volker Musahl5Bryson P. Lesniak6Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterUPMC Freddie Fu Sports Medicine Center3200 S. Water St15203PittsburghPAUSADepartment of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterUPMC Freddie Fu Sports Medicine Center3200 S. Water St15203PittsburghPAUSADepartment of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterUPMC Freddie Fu Sports Medicine Center3200 S. Water St15203PittsburghPAUSAThe Hughston ClinicFort Walton BeachFLUSAMarquette UniversityMilwaukeeWIUSADepartment of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterUPMC Freddie Fu Sports Medicine Center3200 S. Water St15203PittsburghPAUSADepartment of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterUPMC Freddie Fu Sports Medicine Center3200 S. Water St15203PittsburghPAUSAAbstract Purpose The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL‐R) and postoperative meniscus tears. Methods This was a single institution, case–control study of 170 patients status‐post ACL‐R (2010–2019) separated into two matched groups (sex, age, BMI, graft type). Group 1—symptomatic, operative meniscus tears (both de novo and recurrent) after ACL‐R. Group 2—no postoperative meniscus tears. Femoral and tibial tunnel positions were measured by 2 authors via lateral knee radiographs that were used to measure two ratios (a/t and b/h). Ratio a/t was defined as distance from the tunnel center to dorsal most subchondral contour of the lateral femoral condyle (a) divided by total sagittal diameter of the lateral condyle along Blumensaat’s line (t). The ratio b/h was defined as distance between the tunnel and Blumensaat’s line (b) divided by maximum intercondylar notch height (h). Wilcoxon sign‐ranks paired test was used to compare measurements between groups (alpha set at p < 0.05). Results Group 1 had average follow up of 45 months and Group 2 had average follow up of 22 months. There were no significant demographic differences between Groups 1 and 2. Group 1—a/t was 32.0% (± 10.2), which was significantly more anterior than group 2, 29.3% (± 7.3; p < 0.05). There was no difference in average femoral tunnel ratio b/h or tibial tunnel placement between groups. Conclusions A relationship exists between more anterior/less anatomic femoral tunnel position and the presence of recurrent or de novo, operative meniscus tears after ACL‐R. Surgeons performing ACL‐R should strive for recreation of native anatomy via proper tunnel placement to maximize postoperative outcomes. Level of evidence Level III.https://doi.org/10.1186/s40634-023-00630-yAnterior cruciate ligament (ACL)Anterior cruciate ligament reconstruction (ACLR)MeniscusMeniscal repairGraft failureFemoral tunnel position |
| spellingShingle | Jonathan D. Hughes Alexandra S. Gabrielli Jonathan F. Dalton Benjamin T. Raines Daniel Dewald Volker Musahl Bryson P. Lesniak More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears Journal of Experimental Orthopaedics Anterior cruciate ligament (ACL) Anterior cruciate ligament reconstruction (ACLR) Meniscus Meniscal repair Graft failure Femoral tunnel position |
| title | More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears |
| title_full | More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears |
| title_fullStr | More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears |
| title_full_unstemmed | More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears |
| title_short | More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears |
| title_sort | more anterior placement of femoral tunnel position in acl r is associated with postoperative meniscus tears |
| topic | Anterior cruciate ligament (ACL) Anterior cruciate ligament reconstruction (ACLR) Meniscus Meniscal repair Graft failure Femoral tunnel position |
| url | https://doi.org/10.1186/s40634-023-00630-y |
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