CORRELATION BETWEEN TUNEL POSITION ACCORDING TO RADIOLOGICAL DATA AFTER ARTERIOR CRUCIATE LIGAMENT RECONSTRUCTION, SURGEON'S TUNEL ESTIMATION DURING SURGERY AND ANTROPOMETRIC CHARACTERISTICS OF THE PATIENT
Purpose - to assess the correlation between tunnel position according to radiological data after ACL reconstruction and surgeon's estimation during surgery. Material and methods. The study included 86 patients who underwent primary ACL reconstruction with the same surgeon and surgical technique in European Clinic of Sports Traumatology and Orthopedics between 2013 and 2015. In all cases hamstring autograft was used and patients received coronal and sagittal radiographs on the first day after surgery. Surgical data on tunnel position were obtained directly from the OR as dictated by the performing surgeon and fixed in the special registry. Radiological data were exported to eFilm, Merge Healthcare software for graphical analysis. Results. The study group included 54 male and 32 female patients, mean age 35.2 +/- 1.13, range from 17 to 56 years. Analysis of surgical data showed the median femoral tunnel angle on coronal plane to be 45 degrees (IQR 45-60 degrees), angle which occurred most often was 45 degrees, median tibial tunnel angle on coronal plane appeared to be 30 degrees (IQR 30-35 degrees), angle which occurred most often was 30 degrees. According to radiological coronal plane data median femoral tunnel angle accounted 32 degrees (IQR 28-36 degrees), angle which occurred most often was 35 degrees, while median tibial tunnel angle accounted 20 degrees (IQR 17-25 degrees) angle which occurred most often was 19 degrees. Coronal plane mean tibial plateau width was 90.2 +/- 1.1 mm with tibial tunnel center located on the 48.55% from the medial side. Sagittal plane mean tibial plateau depth was 53.8 +/- 0.6 mm with tibial tunnel center located on the 43.95% from the ventral side. Median tibial plateau posterior slope on the sagittal plane accounted 8 degrees (IQR 6-9 degrees). Conclusion. Tunnel placement during arthroscopic ACL reconstruction could hardly be standardized. Anthropometric differences between patients can lead to different bone tunnel positions even if the procedure is performed by the same surgeon and surgical technique.