Reliability of tunnel angle in ACL reconstruction: two-dimensional versus three-dimensional guide technique

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2011-08, Vol.19 (8), p.1258-1264
• Main Authors: Leiter, Jeff R. S., de Korompay, Nevin, MacDonald, Lindsey, McRae, Sheila, Froese, Warren, MacDonald, Peter B.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction - methods; Arthroscopy - methods; Cohort Studies; Confidence Intervals; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional - methods; Joints; Knee; Knee Injuries - diagnostic imaging; Knee Injuries - surgery; Knees; Lifestyle; Ligaments; Male; Measurement; Medicine; Medicine & Public Health; Observer Variation; Orthopedics; Quality of life; Radiography, Interventional - methods; Range of Motion, Articular - physiology; Recovery of Function; Reliability; Reproducibility of Results; Retrospective Studies; Sports; Surgery; Techniques; Tibia - diagnostic imaging; Treatment Outcome; Wire; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-011-1397-0

Purpose To compare the reliability of tibial tunnel position and angle produced with a standard ACL guide (two-dimensional guide) or Howell 65° Guide (three-dimensional guide) in the coronal and sagittal planes. In the sagittal plane, the dependent variables were the angle of the tibial tunnel relative to the tibial plateau and the position of the tibial tunnel with respect to the most posterior aspect of the tibia. In the coronal plane, the dependent variables were the angle of the tunnel with respect to the medial joint line of the tibia and the medial and lateral placement of the tibial tunnel relative to the most medial aspect of the tibia. Methods The position and angle of the tibial tunnel in the coronal and sagittal planes were determined from anteroposterior and lateral radiographs, respectively, taken 2–6 months postoperatively. The two-dimensional and three-dimensional guide groups included 28 and 24 sets of radiographs, respectively. Tibial tunnel position was identified, and tunnel angle measurements were completed. Multiple investigators measured the position and angle of the tunnel 3 times, at least 7 days apart. Results The angle of the tibial tunnel in the coronal plane using a two-dimensional guide (61.3 ± 4.8°) was more horizontal ( P