title: CT assessment of femoral tunnel placement after partial ACL reconstruction.
abstract: BACKGROUND
  When one of the anterior cruciate ligament (ACL) bundles is torn, it seems appropriate to preserve the remaining bundle to improve the vascularization and proprioception of the graft, and to reproduce the attachment sites of the torn bundle. After ACL reconstruction, the functional result is worse when the tunnels are positioned further away from the native ACL's isometric attachment points. The goal of this study was to use CT 3D reconstructions to analyse the position of the femoral tunnel following partial ACL reconstruction and to compare it to complete ACL reconstruction cases. We hypothesized that the femoral tunnel positioning was optimal during partial ACL reconstruction.
  
  
  METHODS
  In this prospective single-centre study, 16 patients who underwent isolated anteromedial bundle reconstruction were evaluated during the immediate postoperative period using 3D reconstruction of CT images. During this same period, 180 patients who underwent complete ACL reconstruction in the same surgery unit served as a control group.
  
  
  RESULTS
  In the partial ACL reconstruction group, 6 tunnels (37.5%) were in the optimal position and 10 tunnels (62.5%) were not. In the complete ACL reconstruction group, 124 femoral (68.9%) were in the optimal position and 56 (31.1%) were not (P<0.05).
  
  
  CONCLUSIONS
  Femoral tunnel positioning is not always optimal in patients who undergo partial ACL reconstruction. Three-dimensional CT reconstruction is a good tool to help surgeons detect and learn from their errors.
  
  
  METHODS
  III (case-control study).
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France. Electronic address: thibault.vermersch@chu-lyon.fr.
authors.forename: T
authors.initials: T
authors.lastname: Vermersch
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Lustig
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Reynaud
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Debette
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Servien
authors.affiliation: Centre Albert-Trillat, groupement hospitalier Nord, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Neyret
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging* / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: 3D CT scan; Anterior cruciate ligament; Femoral tunnel; Partial ACL reconstruction; Partial tear