Knee Surg Relat Res.  2017 Mar;29(1):26-32. 10.5792/ksrr.16.033.

The Effect of Different Sagittal Angles of the Tibial Guide on Aperture Widening of the Tibial Tunnel during Modified Transtibial Anterior Cruciate Ligament Reconstruction: A Randomized In Vivo Study

• Kim YC
• Tawonsawatruk T
• Woon HH
• Yum JW
• Shin MJ
• Bravo RS
• Nha KW

• KMID: 2371530
• DOI: http://doi.org/10.5792/ksrr.16.033

Abstract

PURPOSE
The effect of sagittal plane angle of the tibial tunnel on the severity of tibial intra-articular aperture expansion caused by iatrogenic re-reaming in anterior cruciate ligament (ACL) reconstruction using a modified transtibial technique is unknown. The purpose of this study was to compare the severity of intra-articular aperture widening at different angles (40°, 45°, and 50°) of the tibial guide (TG).
MATERIALS AND METHODS
Ninety-seven patients who underwent modified transtibial ACL reconstruction were randomly allocated to TG 40°, 45°, and 50° groups. Intra-articular tibial aperture width (TW) and tibial tunnel length (TTL) were measured intraoperatively using an arthroscopic ruler and a depth gauge.
RESULTS
The TG 50° group had significantly greater tibial aperture widening than the TG 40° group. There was a significant difference among TG 40°, 45°, and 50° groups and the percentage of knees with TTL <35 mm was 8%, 9% and 3%, respectively. There were 2 females with TTL <35 mm in TG 40° and 45° groups each. The average mediolateral length of the tibial plateau was 75 mm.
CONCLUSIONS
This study shows that the TG angle of 40° would reduce the severity of intra-articular aperture widening of the tibial tunnel compared to 45° or 50° in modified transtibial ACL reconstruction.

Keyword

Knee; Anterior cruciate ligament; Reconstruction; Tibial tunnel; Aperture widening

MeSH Terms

Anterior Cruciate Ligament Reconstruction*
Anterior Cruciate Ligament*
Female
Humans
Knee