Tibial tunnel placement in anterior cruciate ligament reconstructions and graft impingement

Clin Orthop Relat Res. 1992 Oct:(283):187-95.

Abstract

Fifty-six anterior cruciate ligament (ACL) reconstructions had a magnetic resonance scan of the ACL graft six months after operation. The impingement-free grafts (n = 26) had a low magnetic resonance signal from origin to insertion. Impinged grafts (n = 30) had an increased magnetic resonance signal confined to the distal two thirds of the graft. The location of the tibial tunnel (TT) was determined from a lateral roentgenogram. Positioning the center of the TT 12-23 mm from the anterior edge of the tibia consistently produced graft impingement and flexion contractures. Roof impingement was avoided and hyperextension was regained when the TT was centered more posteriorly within a 6-mm impingement-free zone (22-28 mm from the anterior edge of the tibia). Stability and knee extension were significantly better when the center of the TT was 2-3 mm posterior to the center of the normal ACL insertion.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Methods
  • Postoperative Complications* / prevention & control
  • Tibia / surgery*