ANTEROMEDIAL OR CENTRAL ANATOMIC ACL RECONSTRUCTION? A CADAVERIC HIP-TO-TOE STUDY

Area of Science:

• Orthopedic surgery
• Biomechanics
• Anatomy

Background:

• Anterior cruciate ligament (ACL) tears are common knee injuries.
• Anatomic ACL reconstruction aims to restore native ACL pathways.
• Tunnel placement is critical for successful ACL reconstruction outcomes.

Purpose of the Study:

• To compare the biomechanical effects of two distinct anatomic ACL reconstruction tunnel positions.
• To evaluate the impact of anteromedial (AM) versus central (Central REC) tunnel placement on knee stability.

Main Methods:

• Fifteen fresh cadaveric knee specimens underwent isolated ACL deficiency simulation.
• Anatomic ACL reconstruction was performed using either AM REC or Central REC protocols.
• The mechanized pivot-shift test was dynamically assessed using a motion tracking system.

Main Results:

• The Central REC group demonstrated significantly less internal rotation (0.6° ± 0.3°) compared to the AM REC group (1.8° ± 0.3°) during the pivot-shift test (P < 0.05).
• No significant difference in anterior translation was observed between the Central REC (4.7 mm ± 0.4 mm) and AM REC (4.5 mm ± 0.4 mm) groups (P > 0.05).

Conclusions:

• Central anatomic ACL reconstruction provides superior control of internal rotation compared to anteromedial ACL reconstruction.
• Tunnel positioning in anatomic ACL reconstruction significantly influences rotational knee stability.