title: Surgical Adjustment of the Guide Pin to Perform a Correct Tibial Tunnel in Anatomical Anterior Cruciate Ligament Single-Bundle Reconstruction.
abstract: Anatomical positioning of the graft in anterior cruciate ligament reconstruction is important to restore normal knee kinematics and prevent early joint degeneration. Inadequate position of a first attempt to place the guide pin within the center of the tibial footprint may occur. Therefore, its adjustment is important to achieve the anatomical positioning of the graft within the tibial footprint. When the guide pin exits eccentrically in an inadequate position, it is possible to correct it to the center of the footprint. A small tunnel with a 4.5-mm reamer is made and the guide pin is shifted to the center of the footprint. The center of the tunnel can be corrected until 50% and in all direction in relation to the initial drilled tunnel, without additional associated morbidity. Once the correct position of the center is achieved, the guide pin is fixed in the femoral notch roof to guarantee the accurate correction of the axis, without toggling of the guide pin inside the tunnel and metal dusting. The final tunnel is then drilled with the same size of the graft. With this technique it is possible to adjust an eccentrically misplaced guide pin to the center of the footprint without additional morbidity.
authors.affiliation: Orthopaedic Department, Life Line Hospital, Sohar, Oman.
authors.forename: Bharath S
authors.initials: BS
authors.lastname: Kumar
authors.affiliation: Faculty of Sports, University of Porto, Porto, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal.
authors.forename: Renato
authors.initials: R
authors.lastname: Andrade
authors.affiliation: Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; CMEMS Center for MicroElectroMechanical Systems, Mechanical Engineering Department, University of Minho, Guimarães, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Leal
authors.affiliation: Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Orthopaedic Department, Centro Hospitalar Vila Nova de Gaia, Vila Nova de Gaia, Portugal.
authors.forename: André
authors.initials: A
authors.lastname: Sarmento
authors.affiliation: Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal; 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: Hélder
authors.initials: H
authors.lastname: Pereira
authors.affiliation: Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Orthopaedics Department, Hospital de Braga, Braga, Portugal; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Sevivas
authors.affiliation: Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Orthopaedics Department of Minho University, Minho, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Espregueira-Mendes