title: 3D CT analysis of femoral and tibial tunnel positions after modified transtibial single bundle ACL reconstruction with varus and internal rotation of the tibia.
abstract: BACKGROUND
  We analyzed the location of femoral and tibial tunnels by three-dimensional (3D) CT reconstruction images after modified transtibial single bundle (SB) anterior cruciate ligament (ACL) reconstruction, creating a femoral tunnel with varus and internal rotation of the tibia.
  
  
  METHODS
  Data from 50 patients (50 knees) analyzed by 3D CT after modified transtibial SB ACL reconstructions were evaluated. 3D CT images were analyzed according to the quadrant method by Bernard at the femur and the technique of Forsythe at the tibia.
  
  
  RESULTS
  The mean distance of the femoral tunnel center locations parallel to the Blumensaat's line was 29.6%±1.9% along line t measured from the posterior condylar surface. The mean distances perpendicular to the Blumensaat's line were 37.9%±2.5% along line h measured from the Blumensaat's line. At the tibia, the mean anterior-to-posterior distance for the tunnel center location was 37.8%±1.2% and the mean medial-to-lateral distance was 50.4%±0.9%.
  
  
  CONCLUSIONS
  The femoral and tibial tunnels after modified transtibial SB ACL reconstruction creating a femoral tunnel with varus and internal rotation of the tibia (figure-of-4 position) were located between the anatomical anteromedial and posterolateral footprints.
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Jeonha-dong, Dong-gu, Ulsan 682-714, Korea.
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Youm
authors.forename: Sung-Do
authors.initials: SD
authors.lastname: Cho
authors.forename: Jin
authors.initials: J
authors.lastname: Eo
authors.forename: Ki-Jae
authors.initials: KJ
authors.lastname: Lee
authors.forename: Kwang-Hwan
authors.initials: KH
authors.lastname: Jung
authors.forename: Jae-Ryong
authors.initials: JR
authors.lastname: Cha
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000637:transplantation; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult