Evaluation of Tibial and Femoral Tunnel position after Arthroscopic Reconstruction of the Anterior Cruciate Ligament

Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions. Materials: In a cross-sectional study the CT image positions of the tibial and femoral tunnels in 40 patients that had undergone arthroscopic ACL reconstruction using single-bundle hamstring tendon were studied. The parameters that were evaluated were: tibial tunnel position in axial and sagittal cuts femoral tunnel position in axial cut appropriate thickness of the posterior cortex at the intercondylar notch and femoral exit point. The correct position of the tibial and femoral tunnels appropriate thickness of the posterior cortex at the intercondylar notch and the correct position of the "femoral exit point" were respectively recognized in 60% 52.5% 70% and 67.5%. In total the correct position of the femoral and tibial tunnels was seen on 37.5% of patients. These parameters were compared with known standard anatomic positions. Although the incidence of correct tibial and femoral tunnel positioning in ACL reconstruction when viewed separately was acceptable; when looked at as one tunnel was not satisfactory. More precise attention and expertise seem necessary for the operating orthopaedic surgeons.