The lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstruction

2.50
Hdl Handle:
http://hdl.handle.net/11287/595443
Title:
The lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstruction
Authors:
Kassam, Al-Amin; Tillotson, Laura; Schranz, Peter J.; Mandalia, Vipul
Abstract:
Purpose: The aim of the study is to show, on an MRI scan, that the posterior border of the anterior horn of the lateral meniscus (AHLM) could guide tibial tunnel position in the sagittal plane and provide anatomical graft position. Method: One hundred MRI scans were analysed with normal cruciate ligaments and no evidence of meniscal injury. We measured the distance between the posterior border of the AHLM and the midpoint of the ACL by superimposing sagittal images. Results: The mean distance between the posterior border of the AHLM and the ACL midpoint was -0.1mm (i.e. 0.1mm posterior to the ACL midpoint). The range was 5mm to -4.6mm. The median value was 0.0mm. 95% confidence interval was from -0.5 to 0.3mm. A normal, parametric distribution was observed and Intra- and inter-observer variability showed significant correlation (p<0.05) using Pearsons Correlation test (intra-observer) and Interclass correlation (inter-observer). Conclusion: Using the posterior border of the AHLM is a reproducible and anatomical marker for the midpoint of the ACL footprint in the majority of cases. It can be used intra-operatively as a guide for tibial tunnel insertion and graft placement allowing anatomical reconstruction. There will inevitably be some anatomical variation. Pre-operative MRI assessment of the relationship between AHLM and ACL footprint is advised to improve surgical planning.
Citation:
The lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstruction. The Open Orthopaedics Journal. 9, 542-547, 2015
Publisher:
Bentham Open
Journal:
The Open Orthopaedics Journal
Issue Date:
2015
URI:
http://hdl.handle.net/11287/595443
DOI:
10.2174/1874325001509010542
PubMed ID:
26962379
Additional Links:
http://benthamopen.com/FULLTEXT/TOORTHJ-9-542
Note:
The article is available via Open Access.
Type:
Journal Article
Language:
en
ISSN:
1874-3250
Appears in Collections:
2015 RD&E publications; Exeter Knee Reconstruction Unit (EKRU)

Full metadata record

DC FieldValue Language
dc.contributor.authorKassam, Al-Aminen
dc.contributor.authorTillotson, Lauraen
dc.contributor.authorSchranz, Peter J.en
dc.contributor.authorMandalia, Vipulen
dc.date.accessioned2016-02-02T13:58:31Zen
dc.date.available2016-02-02T13:58:31Zen
dc.date.issued2015en
dc.identifier.citationThe lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstruction. The Open Orthopaedics Journal. 9, 542-547, 2015en
dc.identifier.issn1874-3250en
dc.identifier.pmid26962379en
dc.identifier.doi10.2174/1874325001509010542en
dc.identifier.urihttp://hdl.handle.net/11287/595443en
dc.description.abstractPurpose: The aim of the study is to show, on an MRI scan, that the posterior border of the anterior horn of the lateral meniscus (AHLM) could guide tibial tunnel position in the sagittal plane and provide anatomical graft position. Method: One hundred MRI scans were analysed with normal cruciate ligaments and no evidence of meniscal injury. We measured the distance between the posterior border of the AHLM and the midpoint of the ACL by superimposing sagittal images. Results: The mean distance between the posterior border of the AHLM and the ACL midpoint was -0.1mm (i.e. 0.1mm posterior to the ACL midpoint). The range was 5mm to -4.6mm. The median value was 0.0mm. 95% confidence interval was from -0.5 to 0.3mm. A normal, parametric distribution was observed and Intra- and inter-observer variability showed significant correlation (p<0.05) using Pearsons Correlation test (intra-observer) and Interclass correlation (inter-observer). Conclusion: Using the posterior border of the AHLM is a reproducible and anatomical marker for the midpoint of the ACL footprint in the majority of cases. It can be used intra-operatively as a guide for tibial tunnel insertion and graft placement allowing anatomical reconstruction. There will inevitably be some anatomical variation. Pre-operative MRI assessment of the relationship between AHLM and ACL footprint is advised to improve surgical planning.en
dc.language.isoenen
dc.publisherBentham Openen
dc.relation.urlhttp://benthamopen.com/FULLTEXT/TOORTHJ-9-542en
dc.rightsThis is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.en
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.titleThe lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstructionen
dc.typeJournal Articleen
dc.identifier.journalThe Open Orthopaedics Journalen
dc.description.noteThe article is available via Open Access.en
dc.type.versionPublisheden

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