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ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A STUDY OF THE EFFECT OF RADIOLOGICAL IMAGE GUIDANCE ON TUNNEL PLACEMENT.



Abstract

Aim: To study the effect intra-operative image guidance has on the position of both femoral and tibial tunnel placement in primary anterior cruciate ligament reconstruction surgery

Methods: Prospective study of 2 consecutive series of 10 patients undergoing ACL reconstruction surgery all operated on by the same surgeon (the senior author). In the first group intra-operative image guidance in the form of a standard image intensifier was used to guide the surgeon in the positioning of the tibial and femoral tunnels. In the second group no image guidance was used. The position of the femoral and tibial tunnels were assessed on AP and lateral radiographs post operatively and recorded. The two groups were compared.

Conclusion: There was no significant difference in the position of the femoral tunnel position between the 2 groups (p=0.23). There was no significant difference in the position of the tibial tunnel between the 2 groups, in either the AP (p=0.37) or lateral (p=> 0.5) plane. There appears to be no benefit to using an image intensifier to aid in tunnel preparation in ACL reconstruction surgery.

Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.