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A Prospective Evaluation of Femoral Tunnel Placement for Anatomic Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Magnetic Resonance Imaging.

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Τίτλος: A Prospective Evaluation of Femoral Tunnel Placement for Anatomic Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Magnetic Resonance Imaging.
Συγγραφείς: Hart A; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada., Sivakumaran T; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada., Burman M; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada., Powell T; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada., Martineau PA; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.
Πηγή: The American journal of sports medicine [Am J Sports Med] 2018 Jan; Vol. 46 (1), pp. 192-199. Date of Electronic Publication: 2017 Oct 03.
Τύπος έκδοσης: Journal Article; Research Support, Non-U.S. Gov't
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE
Imprint Name(s): Publication: 2004- : Thousand Oaks, CA : Sage Publications
Original Publication: Baltimore, Williams & Wilkins.
Ιατρικοί όροι (MeSH): Magnetic Resonance Imaging*, Anterior Cruciate Ligament Reconstruction/*methods , Femur/*diagnostic imaging , Knee Joint/*diagnostic imaging, Anterior Cruciate Ligament Injuries/surgery ; Cartilage/surgery ; Femur/surgery ; Knee Joint/surgery ; Transplants/surgery ; Adult ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Prospective Studies
Περίληψη: Background: The recent emphasis on anatomic reconstruction of the anterior cruciate ligament (ACL) is well supported by clinical and biomechanical research. Unfortunately, the location of the native femoral footprint can be difficult to see at the time of surgery, and the accuracy of current techniques to perform anatomic reconstruction is unclear.
Purpose: To use 3-dimensional magnetic resonance imaging (3D MRI) to prospectively evaluate patients with torn ACLs before and after reconstruction and thereby assess the accuracy of graft position on the femoral condyle.
Study Design: Cohort study; Level of evidence, 3.
Methods: Forty-one patients with unilateral ACL tears were recruited into the study. Each patient underwent 3D MRI of both the injured and uninjured knees before surgery. The contralateral (uninjured) knee was used to define the patient's native footprint. Patients then underwent ACL reconstruction, and the injured knee underwent reimaging after surgery. The location and percentage overlap of the reconstructed femoral footprint were compared with the patient's native footprint.
Results: The center of the native ACL femoral footprint was a mean 12.0 ± 2.6 mm distal and 9.3 ± 2.2 mm anterior to the apex of the deep cartilage. The position of the reconstructed graft was significantly different, with a mean distance of 10.8 ± 2.2 mm distal ( P = .02) and 8.0 ± 2.3 mm anterior ( P = .01). The mean distance between the center of the graft and the center of the native ACL femoral footprint (error distance) was 3.6 ± 2.6 mm. Comparing error distances among the 4 surgeons demonstrated no significant difference ( P = .10). On average, 67% of the graft overlapped within the native ACL femoral footprint.
Conclusion: Despite contemporary techniques and a concerted effort to perform anatomic ACL reconstruction by 4 experienced sports orthopaedic surgeons, the position of the femoral footprint was significantly different between the native and reconstructed ACLs. Furthermore, each surgeon used a different technique, but all had comparable errors in their tunnel placements.
Contributed Indexing: Keywords: 3D; ACL; MRI; femoral footprint; isotropic imaging
Entry Date(s): Date Created: 20171004 Date Completed: 20190508 Latest Revision: 20190508
Update Code: 20260130
DOI: 10.1177/0363546517730577
PMID: 28972789
Βάση Δεδομένων: MEDLINE
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Header DbId: cmedm
DbLabel: MEDLINE
An: 28972789
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PubType: Academic Journal
PubTypeId: academicJournal
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  Label: Title
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  Data: A Prospective Evaluation of Femoral Tunnel Placement for Anatomic Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Magnetic Resonance Imaging.
– Name: Author
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  Data: <searchLink fieldCode="AU" term="%22Hart+A%22">Hart A</searchLink>; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.<br /><searchLink fieldCode="AU" term="%22Sivakumaran+T%22">Sivakumaran T</searchLink>; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada.<br /><searchLink fieldCode="AU" term="%22Burman+M%22">Burman M</searchLink>; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.<br /><searchLink fieldCode="AU" term="%22Powell+T%22">Powell T</searchLink>; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada.<br /><searchLink fieldCode="AU" term="%22Martineau+PA%22">Martineau PA</searchLink>; Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.
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  Data: <searchLink fieldCode="JN" term="%227609541%22">The American journal of sports medicine</searchLink> [Am J Sports Med] 2018 Jan; Vol. 46 (1), pp. 192-199. <i>Date of Electronic Publication: </i>2017 Oct 03.
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  Data: Journal Article; Research Support, Non-U.S. Gov't
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  Data: English
– Name: TitleSource
  Label: Journal Info
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Sage+Publications%22">Sage Publications </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>7609541 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1552-3365 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2203635465%22">03635465 </searchLink><i>NLM ISO Abbreviation: </i>Am J Sports Med <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: 2004- : Thousand Oaks, CA : Sage Publications<br /><i>Original Publication</i>: Baltimore, Williams & Wilkins.
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  Data: <searchLink fieldCode="MM" term="%22Magnetic+Resonance+Imaging%22">Magnetic Resonance Imaging*</searchLink><br /><searchLink fieldCode="MM" term="%22Anterior+Cruciate+Ligament+Reconstruction%22">Anterior Cruciate Ligament Reconstruction</searchLink>/<searchLink fieldCode="MM" term="%22Anterior+Cruciate+Ligament+Reconstruction+methods%22">*methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Femur%22">Femur</searchLink>/<searchLink fieldCode="MM" term="%22Femur+diagnostic+imaging%22">*diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Knee+Joint%22">Knee Joint</searchLink>/<searchLink fieldCode="MM" term="%22Knee+Joint+diagnostic+imaging%22">*diagnostic imaging</searchLink><br /><searchLink fieldCode="MH" term="%22Anterior+Cruciate+Ligament+Injuries%22">Anterior Cruciate Ligament Injuries</searchLink>/<searchLink fieldCode="MH" term="%22Anterior+Cruciate+Ligament+Injuries+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Cartilage%22">Cartilage</searchLink>/<searchLink fieldCode="MH" term="%22Cartilage+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Femur%22">Femur</searchLink>/<searchLink fieldCode="MH" term="%22Femur+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Knee+Joint%22">Knee Joint</searchLink>/<searchLink fieldCode="MH" term="%22Knee+Joint+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Transplants%22">Transplants</searchLink>/<searchLink fieldCode="MH" term="%22Transplants+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Imaging%2C+Three-Dimensional%22">Imaging, Three-Dimensional</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Prospective+Studies%22">Prospective Studies</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The recent emphasis on anatomic reconstruction of the anterior cruciate ligament (ACL) is well supported by clinical and biomechanical research. Unfortunately, the location of the native femoral footprint can be difficult to see at the time of surgery, and the accuracy of current techniques to perform anatomic reconstruction is unclear.<br />Purpose: To use 3-dimensional magnetic resonance imaging (3D MRI) to prospectively evaluate patients with torn ACLs before and after reconstruction and thereby assess the accuracy of graft position on the femoral condyle.<br />Study Design: Cohort study; Level of evidence, 3.<br />Methods: Forty-one patients with unilateral ACL tears were recruited into the study. Each patient underwent 3D MRI of both the injured and uninjured knees before surgery. The contralateral (uninjured) knee was used to define the patient's native footprint. Patients then underwent ACL reconstruction, and the injured knee underwent reimaging after surgery. The location and percentage overlap of the reconstructed femoral footprint were compared with the patient's native footprint.<br />Results: The center of the native ACL femoral footprint was a mean 12.0 ± 2.6 mm distal and 9.3 ± 2.2 mm anterior to the apex of the deep cartilage. The position of the reconstructed graft was significantly different, with a mean distance of 10.8 ± 2.2 mm distal ( P = .02) and 8.0 ± 2.3 mm anterior ( P = .01). The mean distance between the center of the graft and the center of the native ACL femoral footprint (error distance) was 3.6 ± 2.6 mm. Comparing error distances among the 4 surgeons demonstrated no significant difference ( P = .10). On average, 67% of the graft overlapped within the native ACL femoral footprint.<br />Conclusion: Despite contemporary techniques and a concerted effort to perform anatomic ACL reconstruction by 4 experienced sports orthopaedic surgeons, the position of the femoral footprint was significantly different between the native and reconstructed ACLs. Furthermore, each surgeon used a different technique, but all had comparable errors in their tunnel placements.
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: <i>Keywords: </i>3D; ACL; MRI; femoral footprint; isotropic imaging
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  Data: <i>Date Created: </i>20171004 <i>Date Completed: </i>20190508 <i>Latest Revision: </i>20190508
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  Data: 20260130
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  Data: 10.1177/0363546517730577
– Name: AN
  Label: PMID
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  Data: 28972789
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=28972789
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        Value: 10.1177/0363546517730577
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        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 192
    Subjects:
      – SubjectFull: Anterior Cruciate Ligament Injuries surgery
        Type: general
      – SubjectFull: Cartilage surgery
        Type: general
      – SubjectFull: Femur surgery
        Type: general
      – SubjectFull: Knee Joint surgery
        Type: general
      – SubjectFull: Transplants surgery
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      – SubjectFull: Magnetic Resonance Imaging
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      – SubjectFull: Anterior Cruciate Ligament Reconstruction methods
        Type: general
      – SubjectFull: Femur diagnostic imaging
        Type: general
      – SubjectFull: Knee Joint diagnostic imaging
        Type: general
    Titles:
      – TitleFull: A Prospective Evaluation of Femoral Tunnel Placement for Anatomic Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Magnetic Resonance Imaging.
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