Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model
Purpose Using data from our MRI study, we found that a tunnel oriented 50° externally rotated and 60° cephalad would better connect the fibular collateral ligament (FCL) insertion to the popliteofibular ligament (PFL) insertion as compared to a traditional anterior-to-posterior (A–P) fibular tunnel....
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2015-07, Vol.23 (7), p.1895-1899 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Wechter, John F. Bohm, Kyle C. Macalena, Jeffrey A. Sikka, Robby Singh Tompkins, Marc |
| description | Purpose
Using data from our MRI study, we found that a tunnel oriented 50° externally rotated and 60° cephalad would better connect the fibular collateral ligament (FCL) insertion to the popliteofibular ligament (PFL) insertion as compared to a traditional anterior-to-posterior (A–P) fibular tunnel. The purpose of this study was to test that finding in a cadaver model.
Methods
In eight cadaver knee pairs (16 knees), a guide pin was driven from the fibular FCL insertion point in a 50° externally rotated and 60° cephalad trajectory in 8 knees, and in a traditional A–P trajectory in the contralateral 8 knees. Proximity of the pin to the native PFL insertion, the peroneal and tibial nerves was measured, followed by drilling over the guide pin and measuring the remaining fibular bone stock.
Results
In comparison with the A–P fibular tunnel technique, the 50°/60° technique resulted in a fibular exit point significantly closer to the native PFL insertion (
p
|
| doi_str_mv | 10.1007/s00167-014-3087-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1690218004</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3718579471</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1271-f44aa412a94f2e35984dad75ca68f549c4ecc108448d498af9080408c6e518a83</originalsourceid><addsrcrecordid>eNpdkcFKJDEQhsOirLO6D-BFAl689FrprnQn3mRwdwcE96DnUKbTaw-ZZEy6Bd9qn8EnMzIKspeqgv_j56d-xo4F_BAA3XkGEG1XgcCqAdVV4gtbCGyaqmuw22ML0FhXNcj2gH3LeQ1QTtRf2UGNSqOoxYL5P5Qmvlpd8NsHxyW8_Dtvy-DDeD97SnyaQ3CeT4nWzk4xPfMhJr6NeXIpeiqTPLcxBZd4cjaGPKXZTmMMfAycuKWenoq2ib3zR2x_IJ_d9_d9yO5-Xt0uf1fXN79Wy8vraivqTlQDIlGJRxqH2jVSK-yp76SlVg0StUVnrQCFqHrUigYNChCUbZ0UilRzyM52vtsUH2eXJ7MZs3XeU3Bxzka0GmqhALCgp_-h6zinUNIVSmkpleyaQp28U_P9xvVmm8YNpWfz8ccC1DsgFyn8demTDZi3ssyuLFPKMm9lGdG8Ap_4hKs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1689558573</pqid></control><display><type>article</type><title>Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wechter, John F. ; Bohm, Kyle C. ; Macalena, Jeffrey A. ; Sikka, Robby Singh ; Tompkins, Marc</creator><creatorcontrib>Wechter, John F. ; Bohm, Kyle C. ; Macalena, Jeffrey A. ; Sikka, Robby Singh ; Tompkins, Marc</creatorcontrib><description>Purpose
Using data from our MRI study, we found that a tunnel oriented 50° externally rotated and 60° cephalad would better connect the fibular collateral ligament (FCL) insertion to the popliteofibular ligament (PFL) insertion as compared to a traditional anterior-to-posterior (A–P) fibular tunnel. The purpose of this study was to test that finding in a cadaver model.
Methods
In eight cadaver knee pairs (16 knees), a guide pin was driven from the fibular FCL insertion point in a 50° externally rotated and 60° cephalad trajectory in 8 knees, and in a traditional A–P trajectory in the contralateral 8 knees. Proximity of the pin to the native PFL insertion, the peroneal and tibial nerves was measured, followed by drilling over the guide pin and measuring the remaining fibular bone stock.
Results
In comparison with the A–P fibular tunnel technique, the 50°/60° technique resulted in a fibular exit point significantly closer to the native PFL insertion (
p
< 0.01). Both techniques were safe with regard to the tibial and peroneal nerves. There were no instances of fibular wall blowout in either technique; however, there was less superior bone remaining in the 50°/60° technique (
p
< 0.04).
Conclusion
In a cadaveric model, the 50°/60° technique for PLC reconstruction resulted in a more anatomic-based tunnel than an A–P fibular tunnel.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-014-3087-1</identifier><identifier>PMID: 24894121</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cadaver ; Cadavers ; Drilling ; Fibula - surgery ; Humans ; Knee ; Knee Injuries - diagnosis ; Knee Injuries - surgery ; Knee Joint - surgery ; Ligaments ; Ligaments, Articular - injuries ; Ligaments, Articular - surgery ; Magnetic Resonance Imaging ; Medicine ; Medicine & Public Health ; Orthopedics</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015-07, Vol.23 (7), p.1895-1899</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p1271-f44aa412a94f2e35984dad75ca68f549c4ecc108448d498af9080408c6e518a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-014-3087-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-014-3087-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24894121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wechter, John F.</creatorcontrib><creatorcontrib>Bohm, Kyle C.</creatorcontrib><creatorcontrib>Macalena, Jeffrey A.</creatorcontrib><creatorcontrib>Sikka, Robby Singh</creatorcontrib><creatorcontrib>Tompkins, Marc</creatorcontrib><title>Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Using data from our MRI study, we found that a tunnel oriented 50° externally rotated and 60° cephalad would better connect the fibular collateral ligament (FCL) insertion to the popliteofibular ligament (PFL) insertion as compared to a traditional anterior-to-posterior (A–P) fibular tunnel. The purpose of this study was to test that finding in a cadaver model.
Methods
In eight cadaver knee pairs (16 knees), a guide pin was driven from the fibular FCL insertion point in a 50° externally rotated and 60° cephalad trajectory in 8 knees, and in a traditional A–P trajectory in the contralateral 8 knees. Proximity of the pin to the native PFL insertion, the peroneal and tibial nerves was measured, followed by drilling over the guide pin and measuring the remaining fibular bone stock.
Results
In comparison with the A–P fibular tunnel technique, the 50°/60° technique resulted in a fibular exit point significantly closer to the native PFL insertion (
p
< 0.01). Both techniques were safe with regard to the tibial and peroneal nerves. There were no instances of fibular wall blowout in either technique; however, there was less superior bone remaining in the 50°/60° technique (
p
< 0.04).
Conclusion
In a cadaveric model, the 50°/60° technique for PLC reconstruction resulted in a more anatomic-based tunnel than an A–P fibular tunnel.</description><subject>Cadaver</subject><subject>Cadavers</subject><subject>Drilling</subject><subject>Fibula - surgery</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Injuries - diagnosis</subject><subject>Knee Injuries - surgery</subject><subject>Knee Joint - surgery</subject><subject>Ligaments</subject><subject>Ligaments, Articular - injuries</subject><subject>Ligaments, Articular - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkcFKJDEQhsOirLO6D-BFAl689FrprnQn3mRwdwcE96DnUKbTaw-ZZEy6Bd9qn8EnMzIKspeqgv_j56d-xo4F_BAA3XkGEG1XgcCqAdVV4gtbCGyaqmuw22ML0FhXNcj2gH3LeQ1QTtRf2UGNSqOoxYL5P5Qmvlpd8NsHxyW8_Dtvy-DDeD97SnyaQ3CeT4nWzk4xPfMhJr6NeXIpeiqTPLcxBZd4cjaGPKXZTmMMfAycuKWenoq2ib3zR2x_IJ_d9_d9yO5-Xt0uf1fXN79Wy8vraivqTlQDIlGJRxqH2jVSK-yp76SlVg0StUVnrQCFqHrUigYNChCUbZ0UilRzyM52vtsUH2eXJ7MZs3XeU3Bxzka0GmqhALCgp_-h6zinUNIVSmkpleyaQp28U_P9xvVmm8YNpWfz8ccC1DsgFyn8demTDZi3ssyuLFPKMm9lGdG8Ap_4hKs</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Wechter, John F.</creator><creator>Bohm, Kyle C.</creator><creator>Macalena, Jeffrey A.</creator><creator>Sikka, Robby Singh</creator><creator>Tompkins, Marc</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201507</creationdate><title>Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model</title><author>Wechter, John F. ; Bohm, Kyle C. ; Macalena, Jeffrey A. ; Sikka, Robby Singh ; Tompkins, Marc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1271-f44aa412a94f2e35984dad75ca68f549c4ecc108448d498af9080408c6e518a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Cadaver</topic><topic>Cadavers</topic><topic>Drilling</topic><topic>Fibula - surgery</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Injuries - diagnosis</topic><topic>Knee Injuries - surgery</topic><topic>Knee Joint - surgery</topic><topic>Ligaments</topic><topic>Ligaments, Articular - injuries</topic><topic>Ligaments, Articular - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wechter, John F.</creatorcontrib><creatorcontrib>Bohm, Kyle C.</creatorcontrib><creatorcontrib>Macalena, Jeffrey A.</creatorcontrib><creatorcontrib>Sikka, Robby Singh</creatorcontrib><creatorcontrib>Tompkins, Marc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wechter, John F.</au><au>Bohm, Kyle C.</au><au>Macalena, Jeffrey A.</au><au>Sikka, Robby Singh</au><au>Tompkins, Marc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2015-07</date><risdate>2015</risdate><volume>23</volume><issue>7</issue><spage>1895</spage><epage>1899</epage><pages>1895-1899</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Using data from our MRI study, we found that a tunnel oriented 50° externally rotated and 60° cephalad would better connect the fibular collateral ligament (FCL) insertion to the popliteofibular ligament (PFL) insertion as compared to a traditional anterior-to-posterior (A–P) fibular tunnel. The purpose of this study was to test that finding in a cadaver model.
Methods
In eight cadaver knee pairs (16 knees), a guide pin was driven from the fibular FCL insertion point in a 50° externally rotated and 60° cephalad trajectory in 8 knees, and in a traditional A–P trajectory in the contralateral 8 knees. Proximity of the pin to the native PFL insertion, the peroneal and tibial nerves was measured, followed by drilling over the guide pin and measuring the remaining fibular bone stock.
Results
In comparison with the A–P fibular tunnel technique, the 50°/60° technique resulted in a fibular exit point significantly closer to the native PFL insertion (
p
< 0.01). Both techniques were safe with regard to the tibial and peroneal nerves. There were no instances of fibular wall blowout in either technique; however, there was less superior bone remaining in the 50°/60° technique (
p
< 0.04).
Conclusion
In a cadaveric model, the 50°/60° technique for PLC reconstruction resulted in a more anatomic-based tunnel than an A–P fibular tunnel.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24894121</pmid><doi>10.1007/s00167-014-3087-1</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015-07, Vol.23 (7), p.1895-1899 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1690218004 |
| source | MEDLINE; Wiley Online Library All Journals; SpringerLink Journals - AutoHoldings |
| subjects | Cadaver Cadavers Drilling Fibula - surgery Humans Knee Knee Injuries - diagnosis Knee Injuries - surgery Knee Joint - surgery Ligaments Ligaments, Articular - injuries Ligaments, Articular - surgery Magnetic Resonance Imaging Medicine Medicine & Public Health Orthopedics |
| title | Part II: The 50°/60° fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model |
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