Tunnel placement in anterior cruciate ligament (ACL) reconstruction: quality control in a teaching hospital.

H. Behrend, G. Stutz, M.A. Kessler, A. Rukavina, K. Geisinger, Markus Kuster

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Correct placement of the femoral and tibialbone tunnels is decisive for a successful anterior cruciateligament (ACL) reconstruction. Our method oftunnel placement was evaluated as part of qualitycontrol at a teaching hospital. The emphasis was placedmainly on investigating the influence of surgical experienceon tunnel placement, and the effect of tunnelposition on the clinical outcome. Seventeen surgeonswith different levels of experience (between 0 and >150ACL reconstructions) performed endoscopic ACL repairin uniform technique from August 2000 to August2003 on 50 patients (18 women, 32 men, age range 18–43 years). The patients were available to clinical andradiological follow-up after an average of 19 months.The clinical outcome was classified according to theInternational Knee Documentation Committee(IKDC) standard evaluation form. The femoral tunnelwas evaluated according to the quadrant method ofBernard and Hertel; the position of the tibial bonetunnel was assessed according to the criteria of Sta¨ ubliand Rauschnig. The IKDC score revealed 47 (94%)patients with a normal (A) or nearly normal (B) kneejoint at follow-up. According to the quadrant method,the femoral canal was situated on average at 29% inthe saggital plane. The tibial tunnel was situated onaverage at 43% of the a.p. diameter of the tibial condyle.Statistical analysis of our data showed no significantcorrelation between tunnel placement andsurgical expertise. However, a highly significant correlationwas found (a
Original languageEnglish
Pages (from-to)1159-1165
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume14
DOIs
Publication statusPublished - 2006

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