Positioning of femoral tunnel in anterior cruciate ligament reconstruction using femoral aimer guide

Abstract

Objectives: Anterior Cruciate Ligament (ACL) reconstruction is one of the common procedures. A larger number of ACL injury patients seek treatment to return to preinjury level. Many factors affect the result of reconstruction. Femoral position is one of the important factors. Nowadays, Femoral Aimer Guide is used in to find the proper position of the femoral tunnel but Grontvedt,et al reported the technique was unsatisfactory. Some studies show it is impossible to use the device via transtibial technique for anatomical attachment at femoral site. (22-23) The authors studied the femoral entry point by using the Femoral Aimer Guide both through transtibial tunnel and medial arthrotomy approach. Material and Method: The authors dissected 37 cadaveric knees, removed the ACL and identified the center of the ACL attachment at the femoral side. Used the Femoral Aimer Guide in assisted to find the position of the femoral entry point at 90□ position. Right knee by transtibial technique and left knee by medial arthrotomy technique. Both positions were compared. Results: All positions from the Femoral Aimer Guide entry point did not coincide with isometric point. They tended to move more superior and posterior positions. Some of the aimer positions were far more posterior, and caused the posterior cortex to be thinner than 5 mm. Conclusion: The Femoral Aimer Guide couldn't find the proper position of graft attachment at the femoral side by the standard technique.