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. 2020 Sep 9:59:14-16.
doi: 10.1016/j.amsu.2020.09.012. eCollection 2020 Nov.

Iatrogenic injury of posterolateral structures during femoral tunneling in anterior cruciate ligament reconstruction: A cadaveric study

Sholahuddin Rhatomy  1 , Jaka Fatria Yudhistira  2 , Noha Roshadiansyah Soekarno  3 , Riky Setyawan  4
Affiliations

Iatrogenic injury of posterolateral structures during femoral tunneling in anterior cruciate ligament reconstruction: A cadaveric study

Sholahuddin Rhatomy et al. Ann Med Surg (Lond). .

Abstract

Objective: Creating Femoral tunnel in Anterior Cruciate Ligament (ACL) reconstruction can be done through some portal. Transportal technique commonly preferred by Orthopedic Surgeon. However, this technique may possess some iatrogenic injury to knee structure especially in the posterolateral during the drilling. This study aim is to describe the most susceptible injured posterolateral structure of the knee during femoral tunneling from trans portal technique Anterior Cruciate Ligament (ACL) reconstruction.

Methods: Twenty knees from ten cadavers was examined. Anterior Cruciate Ligament (ACL) reconstruction was simulated using the trans portal technique. Femoral drilling was performed with knee in 120 flexion. The cadaver was dissected to identify the injured posterolateral structure during femoral tunneling. The data collected was anatomy structure and the wound size.

Results: All Twenty knees were included in the study. 90% of injured structure was iliotibial band. The next most common was plantaris (50%) dan gastrocnemius (45%) muscle. The other was biceps femoris muscle (20%). The least common injury was vastus lateralis (5%). No injury was observed in Lateral Collateral Ligament (LCL), popliteus tendon, and peroneal nerve.

Conclusion: Transportal technique during femoral drilling in Anterior Cruciate Ligament (ACL) reconstruction does do damage to some of the posterolateral structure. The injury was considered minimal and may not result in function deterioration. There is also no risk to common peroneal nerve.

Keywords: Anterior cruciate ligament reconstruction; Femoral tunneling; Iatrogenic injury; Posterolateral knee structure; Trans portal technique.

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Conflict of interest statement

There is no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Additional drilling through the far cortex.
Fig. 2
Fig. 2
Identification and measurement of posterolateral knee iatrogenic injury during femoral tunneling.
See this image and copyright information in PMC

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