Positioning of the femoral tunnel for arthroscopic reconstruction of the anterior cruciate ligament: comparative study of 2 techniques
Clinics
; 62(5): 613-618, 2007. ilus, tab
Article
in English
| LILACS
| ID: lil-465119
Responsible library:
BR1.1
ABSTRACT
OBJECTIVE:
To compare the accuracy of positioning of the femoral tunnel in reconstructing the anterior cruciate ligament by means of 2 techniques tibial tunnel and anteromedial portal.METHOD:
Femoral tunnels were drilled in 20 knees from human cadavers by means of arthroscopy. Group I had the femoral tunnel drilled via a trans-tibial tunnel, and Group II via the anteromedial portal. Four variables were measured A) posterior wall thickness; B) tunnel positioning at the notch; C) tunnel inclination in relation to the femoral axis; and D) distance between the wire guide exit and the lateral epicondyle.RESULTS:
As above, respectively, A) 2.23 mm for group I and 2.36 mm for group II (P =.54); B) 25.5° for group I and 30.0° for group II (P =.23); C) 23.9° for group I and 32.0° for group II (P =.02); D) 7.8 cm for group I and 3.9 cm for group II (P <.001).CONCLUSIONS:
Both techniques achieved the desired positioning for the femoral tunnel entrance and satisfactory thickness for the posterior cortex. Drilling via the anteromedial portal may provide greater protection against rupture of the posterior wall.RESUMO
OBJETIVO:
Comparar a acurácia do posicionamento do túnel femoral na reconstrução do ligamento cruzado anterior através de duas vias túnel tibial e portal ântero - medial.MÉTODO:
Foram perfurados túneis femorais em vinte joelhos de cadáveres humanos por via artroscópica. Grupo I túnel femoral por acesso trans túnel tibial. Grupo II via portal ântero-medial. Quatro variáveis foram estudadas A) espessura da parede posterior; B) posicionamento do túnel no intercôndilo; C) angulação do túnel em relação ao eixo do fêmur; D) distância entre a saída do fio guia e o epicôndilo lateral.RESULTADO:
A) grupo I 2,23 mm, grupo II 2,36 mm (p=0,543); B) grupo I 25,5°, grupo II 30° (p=0,226); C) grupo I 23,9°, grupo II 32° (p= 0,014); D) grupo I 7,8 cm, grupo II 3,9 cm (p<0,001).CONCLUSÃO:
As duas técnicas obteveram o posicionamento desejado da entrada do túnel femoral e espessura adequada da cortical posterior. A perfuração via portal ântero-medial pode propiciar maior proteção contra rotura da parede posterior.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Arthroscopy
/
Anterior Cruciate Ligament
/
Femur
Limits:
Humans
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2007
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Sao Paulo University/BR