Comparison of Clinical Outcomes between Different Femoral Tunnel Positions after Anterior Cruciate Ligament Reconstruction Surgery

Backhrounds It has been shown that the proper placement of ACL graft during theACL reconstruction surgery significantly improves the clinical outcomes. This studyinvestigated whether a change in the femoral tunnel position in both axial and coronal planes can significantly alter the postoperative functional and clinical outcomes of thepatientsMethods This comparative, retrospective, single-center study was performed on 44patients undergone single-bundle anterior cruciate ligament reconstruction (ACLR).Radiographic assessments were done to evaluate the tunnel position in coronaland axial planes. Patients were classified into 4 groups based on radiographic data.The time interval between surgery and last visit averaged 2.2 ± 23.6 months (30-18mos.). Lysholm knee score and Cincinnati score were completed for all of the patients.Furthermore, the Lachman, anterior drawer and pivot-shift tests were performed.Results Of the 44 patients included in the study, 9 patients (%20.4) were classifiedas the low-anterior group, %38.6(17) were classified as the low-posterior group and%40.9(18) were classified as the high-posterior group. None of the patients wereincluded in high-anterior group. A greater mean Lysholm score (3±96) in low-posteriorgroup was the only significant difference between the three groups (P<0.001)Conclusions Findings of the current study demonstrated that low-posterior placementof the ACL graft through the intercondylar notch, based on both antero-posterior(AP) and tunnel-view x-rays, is associated with better clinical outcomes in short-termcompared to the routine tunnel placements.