Tibial tunnel positioning on lateral radiographs in anterior cruciate ligament reconstruction: a single surgeon experience


  • Luís Duarte Silva ULS-Guarda, Guarda, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre—FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Portugal; Clínica Medicina Física e Reabilitação, Seia, Portugal http://orcid.org/0000-0003-0033-234X
  • Bruno Maia ULS-Guarda, Guarda, Portugal; Spine Center- Sanfil, Coimbra, Portugal; Seia, Portugal
  • Eduardo Cruz Ferreira ULS-Guarda, Guarda, Portuga
  • Filipa Pires ULS-Guarda, Guarda, Portugal
  • Luís Camarinha ULS-Guarda, Guarda, Portugal




Anterior cruciate ligament, Tunnel placement, Rauching, Surgical accuracy


Background: Accurate tunnel positioning in anterior cruciate ligament reconstruction surgery is one of the cornerstones for its success. However, it is still controversial and target of disagreement within the orthopedic literature. Therefore, it was aimed to evaluate the tibial tunnel placement in anterior cruciate ligament reconstruction surgeries of a single orthopedic surgeon.

Methods: The postoperative knee sagittal radiographs of anterior cruciate ligament reconstructed knees from a single surgeon were retrospectively collected. To assess the tunnel positions was used predefined criteria (in percentage and in millimeters) within the intervals found in the literature (41-43 percent and 21-23 millimeters).

Results: There were no significant differences between the number of results (% and mm), within and without the intervals that were considered acceptable for this measure (P >0.05). It was found significant differences in the absolute deviation (%) throughout non-consecutive years (P <0.05). There was no correlation between the absolute deviations and the years of experience (r =-0.080, P =0.663).

Conclusions: Significant differences were found in the absolute deviation (%) throughout non-consecutive years, suggesting variations in the tunnel position throughout the years. 


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Original Research Articles