{
    "abstract": "Anterior cruciate ligament (ACL) rupture is a common knee injury, and with advancements in knee arthroscopy, ACL reconstruction has become common. Techniques like single-double bundle and femoral tunnel drilling via transtibial or anteromedial portal approaches are available. This study evaluates the accuracy of femoral tunnel placement via these approaches in single-bundle ACL reconstruction.\nForty-three ACL reconstructions using hamstring grafts were analyzed. Initially, femoral tunnels were drilled via the anteromedial portal from 09:30 to 10:00 (14:00 to 14:30 for left knees). Tibial tunnels (mean anteroposterior angle: 63.5\u00b0, sagittal: 64.2\u00b0) were then created with the same diameter, accompanied by radiological documentation. A femoral aiming device was used to place a K-wire at the center of the femoral tunnel, recorded photographically. Tunnel diameters included 7\u00a0mm (20 cases), 7.5\u00a0mm (11 cases), 8\u00a0mm (7 cases), 8.5\u00a0mm (3 cases), and 9\u00a0mm (1 case). Two observers evaluated all radiological and photographic data, focusing on the deviation of the transtibial K-wire from the femoral tunnel center.\nOf 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.\nTranstibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.",
    "authors": [
        {
            "affiliation": "ATOS Klinik Heidelberg, Internationales Zentrum f\u00fcr Orthop\u00e4die, Bismarckstra\u00dfe 9-15, 69115 Heidelberg, Germany - General University Hospital ATTIKO, 1st Surgical Orthopaedic Department of N.K.U.A., Rimini 1, Chaidari, 12462, Greece.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Mastrokalos"
        },
        {
            "affiliation": "General University Hospital ATTIKO, 1st Surgical Orthopaedic Department of N.K.U.A., Rimini 1, Chaidari, 12462, Greece.",
            "firstname": "Anastasios G",
            "initials": "AG",
            "lastname": "Roustemis"
        },
        {
            "affiliation": "General University Hospital ATTIKO, 1st Surgical Orthopaedic Department of N.K.U.A., Rimini 1, Chaidari, 12462, Greece.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Koulalis"
        }
    ],
    "conclusions": "Transtibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.",
    "copyrights": "\u00a9 The Authors, published by EDP Sciences, 2025.",
    "doi": "10.1051/sicotj/2025002",
    "journal": "SICOT-J",
    "keywords": [
        "ACL femoral tunnel positioning",
        "Anterior cruciate ligament",
        "Knee arthroscopy",
        "Single-bundle ACL technique",
        "Transtibial femoral tunnel"
    ],
    "methods": null,
    "publication_date": "2025-02-10",
    "pubmed_id": "39927689\n20888171\n39481077\n23322063\n19910783\n20160627\n19557391\n18843479\n18583137\n19111224\n36917838\n11951198\n14530851\n9051173\n19712449\n12783997\n11573914\n7584195\n15592229\n12627155\n15007318\n35303903\n12750141\n11734492\n1126079\n35006406",
    "results": "Of 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.",
    "title": "Limited accuracy of transtibial aiming for anatomical femoral tunnel positioning in ACL reconstruction.",
    "xml": "<Element 'PubmedArticle' at 0x788504e5ddf0>"
}