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The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()

OBJECTIVE: Violation of the posterior femoral cortex commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament reconstruction (ACLR) and can lead to loss of graft fixation or early graft failure. This study describes and analyzes w...

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Autores principales: Temponi, Eduardo Frois, Oliveira, João Newton Penido, Soares, Luiz Fernando Machado, Carvalho Júnior, Lúcio Honório de
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052188/
https://www.ncbi.nlm.nih.gov/pubmed/30027074
http://dx.doi.org/10.1016/j.rboe.2018.05.011
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author Temponi, Eduardo Frois
Oliveira, João Newton Penido
Soares, Luiz Fernando Machado
Carvalho Júnior, Lúcio Honório de
author_facet Temponi, Eduardo Frois
Oliveira, João Newton Penido
Soares, Luiz Fernando Machado
Carvalho Júnior, Lúcio Honório de
author_sort Temponi, Eduardo Frois
collection PubMed
description OBJECTIVE: Violation of the posterior femoral cortex commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament reconstruction (ACLR) and can lead to loss of graft fixation or early graft failure. This study describes and analyzes whether the femoral tunnel view test can ensure the integrity of the femoral tunnel during ACLR. METHODS: Intraoperative femoral tunnel integrity using the 360° arthroscopic view test was performed in 584 ACLR patients between 2014 and 2016. Posterior wall blowouts were described by their location along the femoral tunnel (i.e., near the aperture or more proximal) and by the depth of the tunnel blowout (<3 mm, 3–5 mm, >5 mm), corresponding to the length of the posterior cortical wall of the violated femoral tunnel. The time spent for the test was measured during ACLR. Complications related to the femoral tunnel view test were also evaluated. RESULTS: The femoral tunnel view test was performed in all 584 patients. In 12 patients (1%), the femoral tunnel presented a posterior cortical blowout that did not extend beyond 3 mm. Only four patients (0.6%) presented posterior wall blowout that extended beyond 5 mm. The time for the test was 40 s (±20 s). No complications related to the test were reported. CONCLUSION: The femoral tunnel view test is effective for ensuring the integrity of the femoral tunnel during ACL reconstruction, without increasing the surgical time and without an increase in the complications rate. CLINICAL RELEVANCE: The femoral tunnel view test is a quick and straightforward test able to provide an adequate view of the patient's anatomy to ensure tunnel integrity during ACLR.
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spelling pubmed-60521882018-07-19 The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity() Temponi, Eduardo Frois Oliveira, João Newton Penido Soares, Luiz Fernando Machado Carvalho Júnior, Lúcio Honório de Rev Bras Ortop Original Article OBJECTIVE: Violation of the posterior femoral cortex commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament reconstruction (ACLR) and can lead to loss of graft fixation or early graft failure. This study describes and analyzes whether the femoral tunnel view test can ensure the integrity of the femoral tunnel during ACLR. METHODS: Intraoperative femoral tunnel integrity using the 360° arthroscopic view test was performed in 584 ACLR patients between 2014 and 2016. Posterior wall blowouts were described by their location along the femoral tunnel (i.e., near the aperture or more proximal) and by the depth of the tunnel blowout (<3 mm, 3–5 mm, >5 mm), corresponding to the length of the posterior cortical wall of the violated femoral tunnel. The time spent for the test was measured during ACLR. Complications related to the femoral tunnel view test were also evaluated. RESULTS: The femoral tunnel view test was performed in all 584 patients. In 12 patients (1%), the femoral tunnel presented a posterior cortical blowout that did not extend beyond 3 mm. Only four patients (0.6%) presented posterior wall blowout that extended beyond 5 mm. The time for the test was 40 s (±20 s). No complications related to the test were reported. CONCLUSION: The femoral tunnel view test is effective for ensuring the integrity of the femoral tunnel during ACL reconstruction, without increasing the surgical time and without an increase in the complications rate. CLINICAL RELEVANCE: The femoral tunnel view test is a quick and straightforward test able to provide an adequate view of the patient's anatomy to ensure tunnel integrity during ACLR. Elsevier 2018-06-11 /pmc/articles/PMC6052188/ /pubmed/30027074 http://dx.doi.org/10.1016/j.rboe.2018.05.011 Text en © 2017 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Temponi, Eduardo Frois
Oliveira, João Newton Penido
Soares, Luiz Fernando Machado
Carvalho Júnior, Lúcio Honório de
The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title_full The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title_fullStr The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title_full_unstemmed The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title_short The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity()
title_sort femoral tunnel view test during acl reconstruction can ensure tunnel integrity()
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052188/
https://www.ncbi.nlm.nih.gov/pubmed/30027074
http://dx.doi.org/10.1016/j.rboe.2018.05.011
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