LAUSR

BackgroundOne of the principal causes for failure of anterior cruciate ligament reconstruction (ACL) is femoral tunnel mal-position. Several studies compare the position of femoral tunnels achieved with various techniques, with small series and using a quadrant assessment method.Questions(1) What is the incidence of anatomical positioning of the intra-articular femoral tunnel aperture in primary ACL reconstruction in a university knee surgery? (2) What are the main errors in positioning?Methods3D-CT scans were performed after primary ACL reconstruction in 135 consecutive cases. The intra-articular position of the femoral tunnel aperture was analyzed using the Magnussen classification.ResultsThe intra-articular tunnel position was deemed anatomical in 77%, intermediate in 20.8%, and non-anatomical in 2.2%. Among the mal-positioned tunnels, 54.8% were vertical, 29% were anteriorly positioned, and 16.1% were both.ConclusionsThe intra articular femoral tunnel aperture was well positioned using an outside-in technique. The main error of tunnel positioning was a tunnel too vertical.Level of Evidence: Level III, prospective study (case series).