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Front. Surg. | doi: 10.3389/fsurg.2018.00016

Arthroscopic Viewing Position Affects Anterior Cruciate Ligament Reconstruction Femoral Tunnel Length Measurements

 Sheeba M. Joseph1, Michael R. Karns1,  Derrick M. Knapik1* and James E. Voos1
  • 1Orthopaedic Surgery, University Hospitals of Cleveland, United States

Purpose: To purpose of this study was to compare arthroscopic anterior cruciate ligament (ACL) reconstruction femoral tunnel length measurements from the anterolateral portal between the standard notch view using a 30° arthroscope versus a “top-down” view utilizing a 70° arthroscope to visual the far side of the femoral tunnel aperture.
Methods: Arthroscopic femoral tunnel length measurements using calibrated reamers from the standard notch versus the “top-down” view were obtained and reviewed in 54 skeletally mature patients undergoing ACL reconstruction with no prior bony knee surgery. Patient age, height, weight, sex, and surgery laterality were also recorded. Measurements of femoral tunnel length were repeated using both views for inter-observer and intra-observer correlation.
Results: Inter-observer and intra-observer intra-class correlation coefficients for the standard notch view and “top-down” views were excellent, with higher reliability values appreciated using the “top down” view. Mean overall femoral tunnel length measurements obtained using the standard notch view were significantly longer than measurements from the “top-down” view (p < 0.001).
Conclusions: The standard notch view provides significantly longer femoral tunnel length measurements in comparison to the “top-down” view.

Keywords: ACL reconstruction, Femoral tunnel length, seventy-degree arthroscopy, Graft-tunnel mismatch, knee arthroscopy

Received: 08 Dec 2017; Accepted: 12 Feb 2018.

Edited by:

Vassilios S. Nikolaou, University General Hospital Attikon, Greece

Reviewed by:

MICHAEL-ALEXANDER MALACHIAS, 2nd Orthopaedic Dpt. University of Athens, Greece
LEONIDAS ROUMELIOTIS, School of Health Sciences, National and Kapodistrian University of Athens, Greece  

Copyright: © 2018 Joseph, Karns, Knapik and Voos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Derrick M. Knapik, KNAPIK., University Hospitals of Cleveland, Orthopaedic Surgery, 11100 Euclid Ave., Cleveland, 11100 Euclid Ave., Hanna House 5043, Ohio, Cleveland, 44106, Ohio, United States,