Comparison of femoral tunnel length and obliquity of anatomic versus nonanatomic anterior cruciate ligament reconstruction: A meta-analysis.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Anterior Cruciate Ligament Injuries*/diagnosis ; Anterior Cruciate Ligament Injuries*/surgery ; Anterior Cruciate Ligament Reconstruction* ; Femur*/diagnostic imaging ; Femur*/surgery ; Tibia*/diagnostic imaging ; Tibia*/surgery ; Tomography, X-Ray Computed*; Female ; Humans ; Male

Purpose: Theoretical considerations suggest that femoral tunnel length might cause graft mismatch, and femoral tunnel obliquity could be related to the longevity of graft in anterior cruciate ligament (ACL) reconstruction. However, controversy still exists regarding these issues in the context of the comparison of anatomic and nonanatomic ACL reconstructions. The purpose of this meta-analysis was to compare the length and obliquity of the femoral tunnel created by drilling through either anatomic or nonanatomic ACL reconstructions.
Materials and Method: In this meta-analysis, we reviewed studies that compared femoral tunnel length and femoral tunnel obliquity in the coronal plane with the use of anatomic or nonanatomic ACL reconstruction. The major databases were reviewed for appropriate studies from the earliest available date of indexing through December 31, 2018. No restrictions were placed on the language of publication.
Results: Twenty-seven studies met the criteria for inclusion in this meta-analysis. The femur tunnel length of anatomic ACL reconstruction was significantly shorter compared with that of nonanatomic ACL reconstruction by 8.66 mm (95% CI: 7.10-10.22 mm; P<0.001), while the femur tunnel obliquity in the coronal plane of anatomic ACL reconstruction was significantly more oblique versus that of nonanatomic ACL reconstruction by 15.29° (95% CI: 8.07°-22.52°; P<0.001). Similar results in terms of femoral tunnel length were found for the subgroup with cadaveric (7.15 mm; 95% CI: 2.69-11.61 mm; P = 0.002) and noncadaveric (8.96 mm; 95% CI: 7.24-10.69 mm; P<0.001) studies, whereas different results in terms of femoral tunnel obliquity were noted for the subgroup with cadaveric (10.62°; 95% CI: -6.12° to 27.37°; P = 0.21) and noncadaveric (15.86°; 95% CI: 8.11°-23.60°; P<0.001) studies.
Conclusion: Anatomic ACL reconstruction resulted in the femoral tunnel length and femoral tunnel obliquity in the coronal plane being shorter and more oblique, respectively, as compared with nonanatomic ACL reconstruction.
Level of Evidence: Therapeutic study, Level III.
Competing Interests: The authors have declared that no competing interests exist.

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Date Created: 20200324 Date Completed: 20200623 Latest Revision: 20200623

20240105

PMC7089554

10.1371/journal.pone.0230497

32203530