| Abstract ID |
| 20260068 |
| Category |
| Knee: ACL |
| Preferable Presentation |
| Oral Presentation |
| Title |
| INDIVIDUALIZED FEMORAL TUNNEL PLACEMENT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BASED ON CONTRALATERAL THREE-DIMENSIONAL MAGNETIC RESONANCE IMAGING |
| Author |
|
| Presenter |
| Vũ Tú Nam |
| Abstract |
| Background: Individualized femoral tunnel placement is essential for restoring native knee biomechanics in anterior cruciate ligament reconstruction; however, reliable intraoperative identification of the femoral footprint center remains challenging, particularly when anatomic landmarks are poorly visualized. Objectives: To evaluate the accuracy of individualized femoral tunnel placement based on contralateral three-dimensional magnetic resonance imaging in single-bundle anterior cruciate ligament reconstruction. Study Design & Methods: This prospective case series included 45 patients undergoing single-bundle anterior cruciate ligament reconstruction using hamstring autografts. Preoperative three-dimensional magnetic resonance imaging of the contralateral uninjured knee was used to define the native femoral footprint center with a rectangular coordinate system. During surgery, an initial experiential femoral tunnel position was identified, followed by intraoperative imaging assessment and correction when required to match the individualized reference. Femoral tunnel center deviation from the contralateral reference was measured before and after correction. Subgroup analysis was performed according to femoral footprint visualization. Results: Mean femoral tunnel deviation decreased significantly from 2.0 ± 1.1 mm at the experiential femoral tunnel position to 0.9 ± 0.4 mm after individualized intraoperative correction (p < 0.001). Initial femoral tunnel deviation was significantly greater in cases without visible femoral footprints compared with those with visible footprints (2.4 ± 1.1 mm versus 1.4 ± 0.7 mm, p < 0.001). Individualized correction guided by contralateral magnetic resonance imaging consistently reduced femoral tunnel deviation across all cases, with the greatest benefit observed in technically challenging knees. Conclusions: Individualized femoral tunnel placement guided by contralateral three-dimensional magnetic resonance imaging significantly improves placement accuracy in anterior cruciate ligament reconstruction, particularly when femoral footprint visualization is limited. |