Drill wobble – effect on femoral tunnel aperture during anterior cruciate ligament reconstruction

被引：0
作者：
Alnusif N. [1 ]
Hart A. [1 ]
Baroudi M. [1 ]
Marien R. [1 ]
Burman M. [1 ]
Martineau P.A. [1 ]
机构：
[1] Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Avenue, A5-175.1, Montreal, H3G 1A4, QC
来源：
Journal of Experimental Orthopaedics | / 3卷 / 1期
关键词：
Anterior cruciate ligament; Anterior cruciate ligament reconstruction failure; Femoral tunnel placement; Wobble effect;
D O I：
10.1186/s40634-016-0073-1
中图分类号：
学科分类号：
摘要：
Background: In anterior cruciate ligament reconstruction performed using cortical button fixation on the femur, we have observed a “wobble” effect that can occur when a cannulated femoral drill is used over a guide pin that is not securely fixed in bone. Our study assessed the effect of drill “wobble” on femoral tunnel aperture in sawbones. Methods: Femoral tunnels were drilled in sawbones, which had been divided in two groups of 10 each, per drilling technique. The “wobble” technique group had the smaller cortical button drill passed before drilling the graft socket with the bigger diameter femoral drill. In contrast, in the “non-wobble” technique group, the smaller cortical button drill was passed after drilling the graft socket. The aperture dimensions: antero-posterior, proximo-distal and oblique, as well as the length of each tunnel, were measured. Results: While the average dimensions of the tunnels were similar between the two techniques, there was significantly more variation in the antero-posterior measurements for the wobble technique as compared to the non-wobble technique (mean 7.3 mm, SD 0.28 mm, and mean 7.3 mm, SD 0.11 mm, respectively; Brown-Forsythe test, p 0.02). Conclusion: We conclude that using the “socket first” “non-wobble” technique is a single surgical technical step surgeons can employ to decrease variability in tunnel aperture and size. © 2016, The Author(s).
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  • [1] Altman D.G., Gore S.M., Gardner M.J., Pocock S.J., Statistical guidelines for contributors to medical journals, Ann Clin Biochem, 29, 1, pp. 1-8, (1992)
  • [2] Bedi A., Raphael B., Maderazo A., Pavlov H., Williams R.J., Transtibial versus anteromedial portal drilling for anterior cruciate ligament reconstruction: a cadaveric study of femoral tunnel length and obliquity, Arthroscopy, 26, 3, pp. 342-350, (2010)
  • [3] Brown M.B., Forsythe A.B., Robust tests for the equality of variances, J Am Stat Assoc, 69, 346, pp. 364-367, (1974)
  • [4] Carson E.W., Anisko E.M., Restrepo C., Panariello R.A., O'Brien S.J., Warren R.F., Revision anterior cruciate ligament reconstruction–etiology of failures and clinical results, J Knee Surg, 17, 3, pp. 127-132, (2004)
  • [5] Chang C.B., Yoo J.H., Chung B.J., Seong S.C., Kim T.K., Oblique femoral tunnel placement can increase risks of short femoral tunnel and cross-pin protrusion in anterior cruciate ligament reconstruction, Am J Sports Med, 38, 6, pp. 1237-1245, (2010)
  • [6] Chen G., Wang S., Comparison of single-bundle versus double-bundle anterior cruciate ligament reconstruction after a minimum of 3-year follow-up: a meta-analysis of randomized controlled trials, Int J Clin Exp Med, 8, 9, (2015)
  • [7] Diamantopoulos A.P., Lorbach O., Paessler H.H., Anterior cruciate ligament revision reconstruction results in 107 patients, Am J Sports Med, 36, 5, pp. 851-860, (2008)
  • [8] Golish S.R., Baumfeld J.A., Schoderbek R.J., Miller M.D., The effect of femoral tunnel starting position on tunnel length in anterior cruciate ligament reconstruction: a cadaveric study, Arthroscopy, 23, 11, pp. 1187-1192, (2007)
  • [9] Hamilton S.C., Jackson E.R., Karas S.G., Anterior cruciate ligament femoral tunnel drilling through anteromedial portal: axial plane drill angle affects tunnel length, Arthroscopy, 27, 4, pp. 522-525, (2011)
  • [10] Hart A., Han Y., Martineau P.A., The apex of the deep cartilage: a landmark and new technique to help identify femoral tunnel placement in anterior cruciate ligament reconstruction, Arthroscopy, 31, 9, pp. 1777-1783, (2015)
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