Results recently published in Arthroscopy showed accurate positioning of the femoral tunnel was achieved with direct arthroscopic visualization of bony landmarks.
Researchers retrospectively reviewed data for 40 patients who underwent ACL reconstruction with either visualization of the lateral condylar wall from the anterolateral portal with drilled tunnels in an outside-in technique or visualization from the anteromedial portal with retrograde drilling performed using an inside-out technique. The study’s primary outcome measure was the placement of the tunnel center point on postoperative CT scans with 3-D reconstruction according to the radiographic quadrant method of Bernard and Hertel. The researchers compared the measurements with optimal placements and assessed reliability with Spearman and intraclass correlation coefficients.
Results showed good interobserver and intraobserver reliability measurements, with a Spearman correlation coefficient between 0.46 and 0.93 and an intraclass correlation coefficient between 0.44 and 0.86. Although both techniques had femoral tunnel positions close to previously published anatomic placements, the researchers found a significant difference between their results and the theoretical position in proximal-distal measurements.
No difference was found in the anteroposterior measurements, and no statistical difference was found between the two techniques in the accuracy of placement of the femoral tunnel center point, according to study results. – by Casey Tingle
Disclosures: Pansard reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.