title: Tibial tunnel aperture location during single-bundle posterior cruciate ligament reconstruction: comparison of tibial guide positions.
abstract: OBJECTIVE
  We aimed to compare posterior cruciate ligament (PCL) tibial tunnel location after tibial guide insertion medial (between the PCL remnant and the medial femoral condyle) and lateral (between the PCL remnant and the anterior cruciate ligament) to the PCL stump as determined by in vivo 3-dimensional computed tomography (3D-CT).
  
  
  METHODS
  Tibial tunnel aperture location was analyzed by immediate postoperative in vivo CT in 66 patients who underwent single-bundle PCL reconstruction, 31 by over-the-PCL and 35 by under-the-PCL tibial guide insertion techniques. Tibial tunnel positions were measured in the medial to lateral and proximal to distal directions of the posterior proximal tibia.
  
  
  RESULTS
  The center of the tibial tunnel aperture was located more laterally (by 2.7 mm) in the over-the-PCL group than in the under-the-PCL group (P = .040) and by a relative percentage (absolute value/tibial width) of 3.2% (P = .031). Tibial tunnel positions in the proximal to distal direction, determined by absolute value and relative percentage, were similar in the 2 groups.
  
  
  CONCLUSIONS
  Tibial tunnel apertures were located more laterally after lateral-to-the-PCL tibial guide insertion than after medial-to-the-PCL tibial guide insertion. There was, however, no significant difference between these techniques in distance from the joint line to the tibial tunnel aperture. Insertion lateral to the PCL stump may result in better placement of the PCL in its anatomic footprint.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Department of Orthopaedic Surgery, Seonam Hospital, Seoul, Republic of Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, Seoul, Republic of Korea.
authors.forename: Seung-Beom
authors.initials: SB
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, Seoul, Republic of Korea.
authors.forename: Yeok-Ku
authors.initials: YK
authors.lastname: Hwang
authors.affiliation: Barunsesang Hospital, Seongnam, Republic of Korea.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: eoak22@empal.com.
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult