Analysis the Lateral Tunnel Position of the Bone Graft and Regeneration of Femur by CT Tunnel Localization

Abstract

Objective: To analyze, in a retrospective study, the lateral tunnel position of the graft femur by CT after arthroscopic ACL reconstruction via the anteromedial (AM) approach and the tunnel angle shown on X-ray. Methods and Materials: 60 patients undergoing arthroscopic ACL reconstruction via AM approach with 4 femoral hamstring tendon grafts were investigated from October 2019 to October 2021. Postoperative orthogonal x-rays and computed tomography (CT) scans were obtained, and the position of the femoral tunnel obtained after CT reconstruction was correlated with the Bernard-Hertel grid. The angle of the resulting femoral tunnel on the orthogonal x-ray was analyzed against the CT tunnel position. Results: In the study, the anterior–posterior orientation was forward (P = 0.001) and the high-low orientation was similar (taken as 20%, P = 0.066) or slightly higher (taken as 21%, P = 0.025) compared to the AM beam localization in the two-beam reconstruction. Overall, the femoral tunnel angle on non-weight-bearing orthogonal x-ray was negatively correlated with the anterior–posterior (AP) position of the femoral tunnel centre as shown on CT (P = 0.004, r =−0.368) and positively, but weakly, correlated with the high-low (HL) position (P = 0.049, r = 0.254). Conclusion: Non-weight-bearing orthogonal X-rays only can make approximate predictions about the distribution of anatomical reconstruction, I.D.E.A.L reconstruction.