Knee Surg Relat Res.  2018 Dec;30(4):348-355. 10.5792/ksrr.18.024.

Minimal Ablation of the Tibial Stump Using Bony Landmarks Improved Stability and Synovial Coverage Following Double-Bundle Anterior Cruciate Ligament Reconstruction

• Kodama Y
• Furumatsu
• Hino T
• Kamatsuki
• Ozaki T

• KMID: 2438116
• DOI: http://doi.org/10.5792/ksrr.18.024

Abstract

PURPOSE
To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction.
MATERIALS AND METHODS
We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes.
RESULTS
Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes.
CONCLUSIONS
Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

Keyword

Knee; Anterior cruciate ligament; Reconstruction; Double-Bundle; Tibial bony landmark

MeSH Terms

Anterior Cruciate Ligament Reconstruction*
Anterior Cruciate Ligament*
Arthroscopy
Humans
Knee
Knee Joint
Retrospective Studies
Transplants