Purpose: The purposes of this study are to describe an ACL femoral tunnel classification system for use in planning revision ACL reconstruction based on 3-D computed tomography (CT) reconstructions and to evaluate its inter- and intra-rater reliability.
Methods: A femoral tunnel classification system was developed based on the location of the femoral tunnel relative to the lateral intercondylar ridge. The femoral tunnel was classified as Type I if it was located entirely below and posterior to the ridge as viewed from distally, Type II if it was slightly malpositioned (either vertically, anteriorly, or both), and Type III if it was significantly malpositioned. To evaluate the reproducibility of the classification system, CT scans of 27 knees were obtained from patients scheduled for revision ACL reconstruction, and 3-D reconstructions were created. Four views of the 3-D reconstruction of each femur were then obtained, and inter- and intra-observer reliability was determined following classification of the tunnels by eight observers.
Results: Twenty-five tunnels were classified as Type I (5 tunnels), Type II (9 tunnels), or type III (11 tunnels) by at least 5 of 8 observers, while insufficient agreement was noted to classify two tunnels. The interobserver reliability of tunnel classification as type I, II, or III yielded a κ coefficient of 0.57, while intra-observer reliability yielded a κ coefficient of 0.67. Subclassification of type II femoral tunnels into the subgroups anterior, vertical, and both was possible in four of the nine type II patients. The interobserver reliability of the complete classification system yielded a κ coefficient of 0.50, while the intra-observer reliability yielded a κ coefficient of 0.54.
Conclusion: Classification of the location of ACL femoral tunnels utilizing 3-D reconstructions of CT data yields moderate to substantial inter- and intra-observer reliability.
Level Of Evidence: Diagnostic Level III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00167-011-1814-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Robot-assisted medial patellofemoral ligament reconstruction in the treatment of recurrent patellar dislocation can improve tunnel accuracy but yields similar outcome compared with traditional technique.
Arthroscopy
January 2025
Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China; Orthopaedics Clinical Medical Research Center of Gansu Province, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China; Intelligent Orthopaedic Industry Technology Center of Gansu Province, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China. Electronic address:
Purpose: To review patients with recurrent patellar dislocation surgically treated with robot-assisted medial patellofemoral ligament (MPFL) reconstruction compared with patients who underwent surgery using the traditional freehand technique.
Methods: A retrospective cohort study was performed to identify patients who underwent MPFL reconstruction from January 2020 to December 2023 in our hospital. The inclusion criteria were: patients aged from 15 to 50 years; patellar dislocation occurred two or more times; a Merchant view or computed tomography (CT) scan indicating patellofemoral joint malalignment, external patellar inclination, or lateral patellar dislocation; underwent MPFL reconstruction via robot-assisted or traditional freehand technique; complete medical records and imaging data before and after surgery; a minimum of 1 year of postoperative follow-up.
[Effectiveness of modified single patellar tunnel medial patella femoral ligament reconstruction for recurrent patellar dislocation].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2025
Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China.
Objective: To investigate the effectiveness of modified single patellar tunnel medial patella femoral ligament (MPFL) reconstruction in the treatment of recurrent patellar dislocation.
Methods: Between January 2023 and June 2023, a total of 61 patients with recurrent patellar dislocation who underwent MPFL reconstruction with autologous semitendinosus were enrolled and divided into 2 groups using random number table method. In the patellar anchor group, 31 patients were treated with MPFL reconstruction with double medial patellar anchors, and 30 patients in the patellar tunnel group were treated with MPFL reconstruction with single patellar tunnel.
Impact of tunnel enlargement on patient-reported outcomes following isolated posterior cruciate ligament reconstruction.
J Orthop Surg Res
January 2025
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, R.O.C, No. 201, Sec. 2, Shih-Pai Road, Beitou District, 112, Taipei, Taiwan.
Background: Tunnel enlargement (TE) might jeopardize knee function and ligament stability after revision surgery of anterior cruciate ligament reconstruction. To date, only few studies concern TE following posterior cruciate ligament reconstruction (PCLR). This study aims to determine TE after isolated PCLR and its relationship with patient-reported outcomes.
View Article and Find Full Text PDFComparison of long-term clinical and radiologic outcomes of AperFix and fixed loop device fixation in anterior cruciate ligament reconstruction: A retrospective study.
Medicine (Baltimore)
January 2025
Department of Orthopaedics and Traumatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey.
Anterior cruciate ligament reconstruction aims to improve knee stability and range of motion. The AperFix system consists of polymer components, and fixed-loop fixation is an established endoscopic technique. Our aim in this study was to compare the long-term clinical and radiological results of AperFix and fixed-loop fixation and to prove that the long-term results of the AperFix fixation method are at least as good as those of the fixed loop device.
View Article and Find Full Text PDFUnlabelled: The increased rate of anterior cruciate ligament (ACL) tears has led to a greater number of revisions. Revision surgery can be performed in one or two stages. Single-stage revision ACL reconstruction (ssRACLR) may be performed when prior tunnels can be re-used or bypassed whereas a two-stage procedure is indicated when bone grafting of dilated tunnels prior to revision is necessary.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!