[Anterior cruciate ligament reconstruction by autogenous bone-patellar tendon-bone graft: correlation between bone-tunnel position and clinical results].
The authors evaluate correlation between bone-tunnel position and clinical results of 50 patients, aged 18-47 years, after anterior cruciate ligament reconstruction by bone-patellar tendon-bone autograft with half-tunnel technique. The evaluation comprises the femoral tunnel placement at the lateral femoral condyle, the angle of the tibial tunnel to the medial joint line of the tibia and paraarticular location of the tibial tunnel width clinical outcome within one to five years prior to operation. Bone-tunnel placement was based on radiograms done in anteroposterior and lateral view. Clinical evaluation was based on the International Knee Documentation Committee (IKDC) scale. Statistical analysis was performed by using Fisher exact test, Mann-Whitney test and chi 2 test with Yates correction. The results show that placement the femoral tunnel anteriorly to the line which was perpendicular to the Blumensaat line where it starts to curve posteriorly and tibial tunnel angle of 75 degrees or more is associated with statistically significant worsened of clinical outcome. Malalignment of femoral tunnel placement characterised much larger effects of qualitative and quantitative changes.