Location of femoral tunnel in anterior cruciate ligament reconstruction using transtibial technique

Objective To study whether transtibial technique in anterior cruciate ligament（ACL） reconstruction can locate the anatomical femoral tunnel. Methods A total of 198 patients underwent arthroscopic single-bundle ACL reconstruction with autogenous semitendinosus tendon and gracilis tendon from June 2007 to February 2010.The position of femoral tunnel was retrospectively evaluated by plain radiography.Of the 198 patients,188 were followed up for an average period of 27 months（range 24-36 months）.The stability and function of knee were evaluated by anterior drawer test,Lachman test and Lycholm scores 12 and 24 months after ACL reconstruction.Spearman correlation analysis was performed. Results Of the 198 patients,171（90%） had an excellent knee stability and a high Lysholm score（83-100）.Radiography showed that femoral tunnel was located in 79%（SD4） of blumensaat′s line and tibial tunnel was located in 41%（SD6） of tibial plateau.The mean inclination of tibial tunnel in the coronal plane was 250（SD3）.The position of bone tunnel was correlated with the Lysholm score. Conclusion Standard surgical technique and anatomical landmarks can achieve optimal tunnel positioning using the transtibial technique for ACL reconstruction.