Right angle to make posteromedial corner tunnels with concomitant posterior cruciate ligament reconstruction. CT evaluation in a cadaveric model

INTRODUCTION: The surface medial collateral ligament (LCMs) and the posterior oblique ligament (POL) are sometimes concomitantly reconstructed with the posterior cruciate ligament (PCL). The objective was to determine the most appropriate angle of the femoral tunnel. MATERIAL AND METHODS: 8 cadaveric knees. Bifascicular LCP tunneling performed arthroscopically. Tunnels LCMs and LOP at 0 ° and 30 ° in axial / coronal planes (0A / 30A // 0C / 0C). Were studied by CT and valued intercondylar relationship, PCL ,and tunnels. A 25mm tunnel was the least considered sufficient RESULTS: The LCMs tunnels 30A / 30C and 30A / 0C measured 31.8 ± 3.2 and 32.2 ± 2.8 mm, respectively, without encroaching on the LCP and 17.4 ± 4 and 17.67 ± 3.8mm intercondylar ceiling. The LCMs 0A / 0C and 0A / 30C tunnels were 5.8 ± 5.2 and 7.2 ± 4.7 of intercondilo respectively, without invasion of the PCL. The LCMs tunnels 0A / 30C in 4 cases ended intraarticulararmente. The LOP 30A / 0C and 30A / 30C measured 33 ± 2.7 and 32.3 ± 3mm, without invasion of the PCL and 16.2 ± 5.7 and 19.3 ± 4.6mm of intercondilo. The LOP 0A / 0C and 0A / 30C tunnels were 6.50 ± 3.9 and 2.9 ± 5.3mm of intercondilo. The LOP tunneled 0A / 30C invaded in 3 cases the PCL tunnels and ended intraarticularly on 7 occasions. CONCLUSIONS: The angulation of the femoral tunnels LCMs and POL have versatility although the LCP is rebuild concomitantly. LCMs tunnels and POL axially oriented at 0° and 30° in coronal planes have high risk of puncturing the joint and in the case of POL also invade LCP tunnels.