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. 2023 Jun 23;57(8):1219-1225.
doi: 10.1007/s43465-023-00929-z. eCollection 2023 Aug.

Freehand vs. Medial Portal Offset Aimer Technique for Accurate Femoral Tunnel Placement in Arthroscopic ACL Reconstruction

Gokhan Pehlivanoglu  1 , Kadir Ilker Yildiz  2
Affiliations

Freehand vs. Medial Portal Offset Aimer Technique for Accurate Femoral Tunnel Placement in Arthroscopic ACL Reconstruction

Gokhan Pehlivanoglu et al. Indian J Orthop. .

Abstract

Purpose: In this study, our aim was to reveal the effect of the medial femoral offset aimer usage through the femoral tunnel entry and exit points and the tunnel length during femoral tunnel drilling in arthroscopic anterior cruciate ligament (ACL) reconstruction.

Methods: One hundred patients who underwent arthroscopic single-bundle ACL reconstruction were included in the study. Group 1 consisted of 50 patients who underwent femoral tunnel drilling using a medial portal offset aimer device, while Group 2 consisted of 50 patients who were operated on using the freehand technique. Both groups were compared in terms of femoral tunnel and graft tunnel lengths, femoral tunnel angle in the coronal plane, and the location of the femoral tunnel entry and exit points.

Results: The mean femoral tunnel and graft tunnel lengths were significantly longer in Group 2 (p = 0.000). There was no significant difference in terms of localization of the femoral tunnel entry point in both the axial and sagittal planes. The tunnel exit point was located significantly more posterior in Group 1 in the axial plane (p = 0.028). There was no significant difference in terms of the coronal plane femoral tunnel angle between the two groups.

Conclusion: In arthroscopic ACL reconstructions, more successful results may be obtained with the freehand technique compared to drilling with a femoral offset aimer. For an experienced orthopedic surgeon, using a medial portal offset aimer device during femoral tunnel drilling does not seem necessary.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-023-00929-z.

Keywords: Anterior cruciate ligament reconstruction; Femoral tunnel; Freehand technique; Medial portal offset aimer.

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Conflict of interest statement

Conflict of interestThe authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
a Arthroscopic view of the femoral tunnel drilling with the freehand technique. b Arthroscopic view of the femoral tunnel drilling with the medial portal offset aimer device
Fig. 2
Fig. 2
a Arthroscopic image of the femoral tunnel length measurement. b Arthroscopic image of the graft tunnel length measurement. c Arthroscopic image of the femoral tunnel-deep cartilage margin distance measurement
Fig. 3
Fig. 3
a Measurement of the angular position of the femoral tunnel entry point on the axial MRI image. b Measurement of the angular position of the femoral tunnel exit point on the axial MRI image. c Measurement of the anteroposterior position of the femoral tunnel on the sagittal MRI image. d Measurement of the inclination angle of the femoral tunnel on the coronal MRI image
See this image and copyright information in PMC

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