Graft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique

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dc.authorid0000-0002-7794-9308
dc.authorid0000-0002-0022-0439
dc.contributor.authorGüler, Olcay
dc.contributor.authorMahiroğulları, Mahir
dc.contributor.authorMutlu, Serhat
dc.contributor.authorÇerçi, Mehmet Halis
dc.contributor.authorŞeker, Ali
dc.contributor.authorÇakmak, Selami
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:35:39Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:35:39Z
dc.date.issued2016
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractIntroduction: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. Materials and methods: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7 months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel. Results: Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78° and 46.80° (p < 0.01). With respect to TT patients, ACL graft angle was 58.87° and 70.04° on sagittal and frontal planes in operated knees versus 47.38° and 61.82° in healthy knees (p < 0.001). ACL graft angle was significantly different between the groups on both sagittal and frontal planes (p < 0.001). Sagittal graft insertion tibia midpoint distance ratio was 0.51 and 0.48 % in the operated and healthy knees of AM group (p < 0.001) and 0.51 and 0.48 % in TT group (p < 0.001). Sagittal tibial tunnel midpoint distance ratio did not differ from sagittal graft insertion tibia midpoint distance of healthy knees in either group. Femoral tunnel clock position was better in AM [right knee 10:19 o’clock-face position (310° ± 4°); left knee 1:40 (50° ± 3°)] compared with TT group [right knee 10:48 (324° ± 5°); left knee 1:04 (32° ± 4°)]. With respect to the sagittal plane, the anterior–posterior position of femoral tunnel was better in AM patients. Lysholm scores and range of motion of operated knees in the AM and TT groups showed no significant difference (p > 0.05). Conclusions: Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane.
dc.identifier.citationGüler, O., Mahiroğulları, M., Mutlu, S., Çerçi, M. H., Şeker, A. ve Çakmak, S. (2016). Graft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique. Archives of Orthopaedic and Trauma Surgery, 136(11), 1571-1580. https://dx.doi.org/10.1007/s00402-016-2532-7
dc.identifier.doi10.1007/s00402-016-2532-7
dc.identifier.endpage1580
dc.identifier.issn0936-8051
dc.identifier.issue11
dc.identifier.scopusqualityQ1
dc.identifier.startpage1571
dc.identifier.urihttps://hdl.handle.net/20.500.12511/887
dc.identifier.urihttps://dx.doi.org/10.1007/s00402-016-2532-7
dc.identifier.volume136
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer Verlag
dc.relation.ispartofArchives of Orthopaedic and Trauma Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAnterior Cruciate Ligament Reconstruction
dc.subjectAnteromedial Technique
dc.subjectLysholm Scoring
dc.subjectSingle-Bundle ACL Reconstruction
dc.subjectTibial Tunnel
dc.titleGraft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique
dc.typeArticle

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