title: Comparison of femoral tunnel geometry, using in vivo 3-dimensional computed tomography, during transportal and outside-in single-bundle anterior cruciate ligament reconstruction techniques.
abstract: OBJECTIVE
  To compare the transportal (TP) and outside-in (OI) techniques regarding femoral tunnel position and geometry after anatomic single-bundle (SB) anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  This study included 51 patients who underwent anatomic SB ACL reconstruction with the TP (n = 21) or OI (n = 30) technique. All patients underwent 3-dimensional computed tomography 3 days after the operation. The femoral tunnel position (quadrant method), femoral graft bending angle, femoral tunnel length, and posterior wall breakage were assessed by immediate postoperative 3-dimensional computed tomography with OsiriX imaging software.
  
  
  RESULTS
  The OI technique had a shallower femoral tunnel position (arthroscopic position) than did the TP technique (P = .005). The mean femoral graft bending angle was significantly more acute with the OI technique (101.3° ± 8.2°) than with the TP technique (107.9° ± 10.0°) (P = .02). The mean femoral tunnel length was significantly greater with the OI technique (33.0 ± 3.5 mm) than with the TP technique (29.6 ± 3.9 mm) (P = .003). Posterior wall breakage occurred in 7 cases (33.3%) with the TP technique and 1 case (3.3%) with the OI technique (P = .02).
  
  
  CONCLUSIONS
  The mean femoral tunnel position was significantly shallower (arthroscopic position) with the OI technique than with the TP technique. The OI technique resulted in a more acute femoral graft bending angle, longer femoral tunnel length, and lower incidence of posterior wall breakage than did the TP technique. These results might be helpful for anatomic SB ACL reconstruction using TP and OI techniques.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Gyeonggi-do, South Korea.
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Gyeonggi-do, South Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Sung Kyun Kwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Gyeonggi-do, South Korea.
authors.forename: Chi Heon
authors.initials: CH
authors.lastname: Oh
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Guro Hospital, Seoul, South Korea.
authors.forename: Myung Hoi
authors.initials: MH
authors.lastname: Hwang
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Gyeonggi-do, South Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Gyeonggi-do, South Korea. Electronic address: jgkim7437@gmail.com.
authors.forename: Jae Gyoon
authors.initials: JG
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult