Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament

Yuya Kodama, Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Takaaki Tanaka, Hiroto Inoue, Toshihumi Ozaki

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r 2=0.64; p<0.001), with a cutoff distance of 5mm having a sensitivity to extrusion of 83% and specificity of 93%. The mean extrusion for a distance >5mm was 0.40±0.43mm, compared to 1.40±0.51mm for a distance ≤5mm (p<0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction.

Original languageEnglish
JournalJournal of Orthopaedic Research
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Tibial Meniscus
Anterior Cruciate Ligament Reconstruction
Tomography
Anterior Cruciate Ligament
Proxy
Knee
Magnetic Resonance Spectroscopy
Wounds and Injuries

Keywords

  • Anterior cruciate ligament
  • Lateral meniscal extrusion
  • Lateral meniscus

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

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title = "Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament",
abstract = "The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r 2=0.64; p<0.001), with a cutoff distance of 5mm having a sensitivity to extrusion of 83{\%} and specificity of 93{\%}. The mean extrusion for a distance >5mm was 0.40±0.43mm, compared to 1.40±0.51mm for a distance ≤5mm (p<0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction.",
keywords = "Anterior cruciate ligament, Lateral meniscal extrusion, Lateral meniscus",
author = "Yuya Kodama and Takayuki Furumatsu and Shinichi Miyazawa and Masataka Fujii and Takaaki Tanaka and Hiroto Inoue and Toshihumi Ozaki",
year = "2017",
doi = "10.1002/jor.23450",
language = "English",
journal = "Journal of Orthopaedic Research",
issn = "0736-0266",
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T1 - Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament

AU - Kodama, Yuya

AU - Furumatsu, Takayuki

AU - Miyazawa, Shinichi

AU - Fujii, Masataka

AU - Tanaka, Takaaki

AU - Inoue, Hiroto

AU - Ozaki, Toshihumi

PY - 2017

Y1 - 2017

N2 - The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r 2=0.64; p<0.001), with a cutoff distance of 5mm having a sensitivity to extrusion of 83% and specificity of 93%. The mean extrusion for a distance >5mm was 0.40±0.43mm, compared to 1.40±0.51mm for a distance ≤5mm (p<0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction.

AB - The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r 2=0.64; p<0.001), with a cutoff distance of 5mm having a sensitivity to extrusion of 83% and specificity of 93%. The mean extrusion for a distance >5mm was 0.40±0.43mm, compared to 1.40±0.51mm for a distance ≤5mm (p<0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction.

KW - Anterior cruciate ligament

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