How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction.

Massimo Midiri, Lawrence Camarda, Michele D'Arienzo, Emanuele Grassedonio, Michele Lauria

Risultato della ricerca: Articlepeer review

8 Citazioni (Scopus)

Abstract

PURPOSE: The purpose of the present study was to assess the risk of femoral tunnel collisions between the medial collateral ligament (MCL) and the posterior cruciate ligament (PCL) tunnels during a simultaneous PCL and MCL reconstruction.METHODS: Fourth generation medium and large synthetic femur bones were used. On each femur, a MCL tunnel and a PCL tunnel were reamed. The MCL tunnel was drilled at 0°, 20° and 40° of axial and coronal angulations. The PCL femoral tunnel was reamed to simulate two different tunnel directions that could be obtained through an inside-out and outside-in technique. Tunnels were filled with epoxy resin augmented with BaSO4, and a multidetector CT examination of each specimen was performed.RESULTS: High rate of tunnel collision (62.5 %) was found when the MCL femoral tunnel was reamed with a coronal angulation of 0° and 20°. The rate of tunnel collision significantly decreased (0 %) when the MCL tunnel was reamed proximally with a coronal angulation of 40°. No differences were found between the two PCL tunnel directions in terms of tunnel collision.CONCLUSION: The results of this study can help surgeons to better direct the femoral MCL tunnel in order to avoid a collision between femoral tunnels during a combined MCL and PCL reconstruction. In order to minimize such potential complications, the MCL tunnel should be created limiting the axial angulation and it should be drilled with a proximal angulation from 20° to 40°, depending on the medial condyle width.
Lingua originaleEnglish
pagine (da-a)2767-2772
Numero di pagine6
RivistaKnee Surgery, Sports Traumatology, Arthroscopy
Volume9
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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