title: FEMORAL TUNNELS' LENGTH CHANGES WITH KNEE FLEXION ANGLE IN ANATOMICAL ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.
abstract: OBJECTIVE
  The objective of our study was to evaluate the effect that knee flexion angle while femoral tunnels are being drilled may have on the length of these tunnels, in anatomical reconstruction of the anterior cruciate ligament.
  
  
  METHODS
  We measured the lengths of anteromedial and posterolateral tunnels for the anterior cruciate ligament in 20 unpaired anatomical knee specimens (10 right and 10 left knees), all with the cartilage and cruciate ligaments intact. Tunnels were drilled with the knees flexed at 90°, 110° and 130°, through the accessory anteromedial portal, with a 2.5 mm drill. The statistical analysis was done by means of Friedman's variance analysis and the Mann-Whitney U test.
  
  
  RESULTS
  The mean anteromedial femoral tunnel lengths measured with the knees flexed at 90°, 110° and 130° were 33.7 (± 3.72) mm, 37.4 (± 2.93) mm and 38.8 (± 3.31) mm, respectively. For the posterolateral femoral tunnel lengths, the results were 32.1 (± 4.24) mm, 37.3 (± 4.85) mm and 38.4 (± 2.51) mm, respectively. Friedman's variance analysis showed that there was a significant difference between the lengths of the tunnels drilled with 90° and 110° of flexion angle, but showed that there was no significant difference between the tunnels drilled with flexion of 110° and 130° (P < 0.05).
  
  
  CONCLUSIONS
  It is possible to drill the femoral tunnels through the accessory anteromedial tunnel with the knee flexed at 110° in such a way as to produce a tunnel of sufficient length for a good bone-graft interface.
authors.affiliation: PhD in Orthopedics and Traumatology from the USP School of Medicine; Voluntary Attending Physician in the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Gali
authors.affiliation: Former Resident in the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Heetor Campora
authors.initials: HC
authors.lastname: de Sousa Oliveira
authors.affiliation: Former Resident in the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Bruno Asprino
authors.initials: BA
authors.lastname: Ciancio
authors.affiliation: Former Resident in the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Marcos Vianna
authors.initials: MV
authors.lastname: Palma
authors.affiliation: Former Resident in the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Full Professor and Head of the Orthopedics and Traumatology Service, Sorocaba School of Medical and Health Sciences, Pontificate Catholic University of São Paulo, Sorocaba, SP, Brazil.
authors.forename: Edie Benedito
authors.initials: EB
authors.lastname: Caetano
keywords: Anterior Cruciate Ligament; Femur; Knee; Reconstructive Surgical Procedures; Tibia