Femoral tunnel position in anatomical double-bundle ACL reconstruction is not affected by Blumensaat's line morphology.

The aim of this study was to reveal the influence of the morphological variations of the Blumensaat's line on antero-medial (AM) and postero-lateral (PL) femoral tunnel position in anatomical double-bundle anterior cruciate ligament (ACL) reconstruction. Fifty-three subjects undergoing anatomical double-bundle ACL reconstruction were included (29 female, 24 male: median age 27.4:14-50 y.o.). Using an inside-out transportal technique, the PL tunnel position was made on a line drawn vertically from the bottommost point of the lateral condyle at 90° of knee flexion, spanning a distance of 5 to 8 mm, to the edge of the joint cartilage. AM tunnel position was made 2 mm distal to the PL tunnel position. Following Iriuchishima's classification, the morphology of the Blumensaat's line was classified into straight and hill (large and small) types. Femoral tunnel position was determined using the quadrant method. A Mann-Whitney's U test was performed to compare straight and hill type knees according to AM and PL femoral tunnel position. There were 18 straight and 35 hill type knees (13 small and 22 large hill). AM and PL femoral tunnel position in straight type knees was 21.7 ± 7.0%, 33.6 ± 10.5% in the shallow-deep direction, and 42.1 ± 11.1%, 72.1 ± 8.5% in the high-low direction, respectively. In hill type knees, AM and PL femoral tunnel position was 21.3 ± 5.8%, 36.9 ± 7.1% in the shallow-deep direction, and 44.6 ± 10.7%, 72.1 ± 9.7% in the high-low direction, respectively. No significant difference in AM or PL femoral tunnel position was detected between straight and hill type knees. AM and PL femoral tunnel position in anatomical double-bundle ACL reconstruction was not affected by the morphological variations of the Blumensaat's line. Surgeons do not need to consider Blumensaat's line morphology if AM and PL femoral tunnel position is targeted at the bottommost point of the lateral condyle. Level of evidence Ⅳ. Keywords ACL; double-bundle ACL reconstruction; Blumensaat's line; femoral tunnel position.

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.