title: Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  To investigate which technique would reduce bending stress at the femoral tunnel aperture and make short tunnel length after ACL reconstruction by comparing the femoral graft bending angle and tunnel length between the single-bundle (SB) transtibial (TT) and double-bundle (DB) transportal (TP) technique using three-dimensional-computed tomography using OsiriX(®) imaging software.
  
  
  METHODS
  Forty-nine patients underwent an ACL reconstruction using a SB TT (Group I, 20 patients) and DB TP (Group II, 29 patients) technique. Femoral graft bending angle and femoral tunnel length were measured by CT image using OsiriX(®) imaging software. Groups I and II were compared, and statistical analysis was performed using SPSS software.
  
  
  RESULTS
  The mean anteromedial (AM) and posterolateral (PL) femoral graft bending angle of group II (111.5 ± 8.8° and 118.9 ± 9.8°, respectively) was significantly more acute than that of group I (125.3 ± 11.1°) (P < 0.001, P = 0.04). The mean femoral tunnel length of group I was significantly longer than that of group II (P = 0.001).
  
  
  CONCLUSIONS
  The femoral graft bending angle and the femoral tunnel length of the TP technique performed in the maximally flexed knee position was more acute and shorter than those of the TT technique after ACL reconstruction. This might increase the bending stress at the femoral tunnel aperture and shorter graft length in the tunnel after an ACL reconstruction using TP technique compared to the TT technique.
  
  
  METHODS
  III.
authors: Department of Orthopaedic Surgery, School of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea.
authors: Joon Ho
authors: JH
authors: Wang
authors: Jae Gyoon
authors: JG
authors: Kim
authors: Do Kyung
authors: DK
authors: Lee
authors: Hong Chul
authors: HC
authors: Lim
authors: Jin Hwan
authors: JH
authors: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005269:Femur / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D015588:Observer Variation; D019651:Plastic Surgery Procedures; D013710:Tendons / Q000000981:diagnostic imaging / Q000637:transplantation; D013977:Tibia / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult