title: In vivo evaluation of femoral and tibial graft tunnel placement following all-inside arthroscopic tibial inlay reconstruction of the posterior cruciate ligament.
abstract: BACKGROUND
  The arthroscopic all-inside tibial inlay technique represents a novel procedure for posterior cruciate ligament (PCL) reconstruction. However, in vivo investigations that evaluate the accuracy of this technique regarding anatomic graft tunnel placement are few. The objective of this study was to analyse the femoral and tibial tunnel apertures using computed tomography (CT) and compare these findings to recommendations in the literature.
  
  
  METHODS
  CT scans were obtained in 45 patients following single-bundle PCL reconstruction. The centres of the tibial and femoral tunnel apertures were correlated to measurement grid systems used as a radiographic reference.
  
  
  RESULTS
  The centre of the femoral tunnel aperture was located at 42.9% ± 9.4% of the total intercondylar depth and at 12.9% ± 7.2% of the total intercondylar height. The angle α for the femoral tunnel position was measured at 64.2° ± 10.0°. The centre of the tibial tunnel aperture was found at 51.8% ± 4.1% of the total mediolateral diameter of the tibial plateau. The superoinferior distance of the tibial tunnel aperture to the joint line was 9.6 mm ± 4.4 mm on frontal and 9.3 mm ± 3.4 mm on sagittal 3D-CT scans. The distance of the tibial tunnel aperture to the former physis line averaged to 0.8 mm ± 3.4 mm. Comparison to the corresponding reference values revealed no statistically significant difference.
  
  
  CONCLUSIONS
  Arthroscopic tibial inlay reconstruction is an efficient procedure for precise replication of the anatomical footprint of the PCL.
  
  
  METHODS
  IV, prospective case series.
authors.affiliation: Academic Hospital Feldkirch, Department for Trauma Surgery and Sports Traumatology, Carinagasse 47, 6800 Feldkirch, Austria. Electronic address: michael.osti@lkhf.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Osti
authors.affiliation: Academic Hospital Feldkirch, Department for Radiology, Carinagasse 47, 6800 Feldkirch, Austria.
authors.forename: Alessa
authors.initials: A
authors.lastname: Krawinkel
authors.affiliation: Academic Hospital Feldkirch, Department for Trauma Surgery and Sports Traumatology, Carinagasse 47, 6800 Feldkirch, Austria.
authors.forename: Karl Peter
authors.initials: KP
authors.lastname: Benedetto
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000601:surgery*; D052097:Quadriceps Muscle; D013710:Tendons / Q000637:transplantation; D013977:Tibia / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroscopy; PCL reconstruction; Posterior cruciate ligament; Tibial inlay technique