Acta Medica Okayama volume74 issue4
2020-08 発行

Tibial Tunnel Positioning Using the Posterolateral (PL) Divergence Guide in Anterior Cruciate Ligament Reconstruction

Tanaka, Takaaki Department of Orthopaedic Surgery, Sumitomobesshi Hospital
Furumatsu, Takayuki Department of Orthopaedic Surgery, Okayama University Hospital Kaken ID publons
Hiranaka, Takaaki Department of Orthopaedic Surgery, Okayama University Hospital
Okazaki, Yuki Department of Orthopaedic Surgery, Okayama University Hospital
Masudaa, Kenji
Senoa, Noritaka Department of Orthopaedic Surgery, Sumitomobesshi Hospital
Ozaki, Toshifumi Department of Orthopaedic Surgery, Okayama University Hospital Kaken ID publons researchmap
Publication Date
2020-08
Abstract
The aim of this study was to evaluate tunnel coalition and inter-tunnel distance by comparing the tibial tunnel position in double-bundle anterior cruciate ligament (ACL) reconstruction performed with a conventional guide versus a posterolateral (PL) divergence (PLD) guide. Subjects were 43 patients (ACL tip aimer: 20 knees; PLD guide: 23 knees) who underwent double-bundle ACL reconstruction between September 2014 and December 2017. In all cases, the tibial tunnel position, tunnel edge distance and tunnel angles were evaluated based on CT images. Clinical outcome was evaluated using the Lachman test, pivot-shift test, and Lysholm score. Tibial tunnel positions were similar between the conventional and PLD guide groups, while tibial tunnel edge distance was significantly less in the conventional group. Tunnel coalition was observed in 5 knees in the conventional and no knees in the PLD guide group. Distance between two tibial tunnel centers was 9.1 mm for the tip aimer, and 10.5 mm for the PLD guide. Creation of the PL tunnel tended to involve insertion from a more medial aspect for the PLD guide group than the conventional guide group. No differences in clinical outcomes were noted. The PLD guide can be used to create anatomically-positioned PL tunnels, and reduce the probability of occurrence of tunnel coalition.
Document Type
Original Article
Keywords
anterior cruciate ligament reconstruction
tibial tunnel position
PL divergence guide
tunnel coalition
Link to PubMed