More anterior placement of femoral tunnel position in ACL-R is associated with postoperative meniscus tears

Purpose The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL-R) and postoperative meniscus tears. Methods This was a single institution, case–control study of 170 patients status-post ACL-R (2010–2019) separated into two matched groups (sex, age, BMI, graft type). Group 1—symptomatic, operative meniscus tears (both de novo and recurrent) after ACL-R. Group 2—no postoperative meniscus tears. Femoral and tibial tunnel positions were measured by 2 authors via lateral knee radiographs that were used to measure two ratios (a/t and b/h). Ratio a/t was defined as distance from the tunnel center to dorsal most subchondral contour of the lateral femoral condyle (a) divided by total sagittal diameter of the lateral condyle along Blumensaat’s line (t). The ratio b/h was defined as distance between the tunnel and Blumensaat’s line (b) divided by maximum intercondylar notch height (h). Wilcoxon sign-ranks paired test was used to compare measurements between groups (alpha set at p