Description
The tibial attachment of the anterior cruciate ligament (ACL) and the anterior horn of the lateral meniscus (AHLM) were reported to be close to each other. This study aimed to evaluate the relationship between the tibial bone tunnel and AHLM perforation and to investigate AHLM perforation during surgery and lateral meniscus extrusion (LME) one year after ACL reconstruction.
Methods: *
A retrospectively collected database and associated intraoperative findings for 63 patients undergoing primary anatomical ACL reconstruction with a single or double bundle from 2015 to 2022 were investigated. Those cases had no meniscal injury seen at surgery and more than a one-year follow-up. We calculated the percentage of perforation by the length of attachment of AHLM before and three months after surgery using MRI. The LME changes from preoperative to one year after surgery were compared between the single bundle and the double-bundle ACL reconstruction. The location of the center of the tibial tunnel was evaluated by the position relative to the medial tibial eminence with two measures, the medial-lateral and the anterior-posterior distance with the 3D-CT image.
Results: *
The tibial tunnel positions were within the tibial footprint of ACL insertion site on both groups. On the tibial position in the single group, the mean location position of the tibial tunnel was at 37.3%±5.3% of the anteroposterior length and 47.3%±3.8% from medial to lateral. In case of the double group, the mean location position of the anterior-medial (AM) tunnel was at 26.0%±4.8% and posterior-lateral (PL) tunnel was at 40.6±4.8% of the anteroposterior length (AP)and AM was 46.1%±3.0% PL was 47.0±2.4% from medial to lateral. The perforation width of AHLM was 2.1±2.3㎜and 0.5±1.1㎜in the single and the double group, srespectively (P=0.001). However, There was no significant correlation between the LME difference from pre to post LME and postoperative width of AHLM attachment.
Conclusions: *
The creation of tibial tunnel made the single bundle has more AHLM perforatetion in the single-bundle reconstruction than that of the double- bundle reconstruction, however, no difference in LME difference from pre to post LME between two groups.
