A clinical and radiographic approach for establishing proper tibial tubercle transfer when using quad active femoral nerve stimulation.

Background: The tibial tubercle-trochlear groove measurement (TT-TG), which measures the lateral offset of the tibial tubercle relative to the trochlear groove of the femur, has been utilized as an intraoperative tool to help establish maximum patellofemoral congruency in patients who suffer from patellar instability. We have previously published our approach of establishing how far to transfer the tibial tubercle using intraoperative femoral nerve stimulation in order to achieve congruency from 0-30° of flexion. The technique and clinical outcomes have previously been published in this journal and elsewhere.

Double-bundle ACL reconstruction: novice surgeons utilizing computer-assisted navigation versus experienced surgeons.

Purpose: Anatomic double-bundle ACL reconstruction presents a unique technical challenge for surgeons, requiring precise placement of multiple tunnels in a relatively small area. As the necessity of anatomic reconstruction has been stressed throughout the literature, developing a method to consistently improve the accuracy and precision of tunnel placement is essential. We aimed to investigate whether computer-assisted navigation allows novice surgeons to place double-bundle ACL tunnels with a similar degree of accuracy to experienced surgeons operating without computer assistance.