P227 - Use of a Femoral Offset Guide Provides Accurate and Precise Placement of Femoral Tunnel in Anterior Cruciate Ligament Reconstruction
Abstract
Purpose
The purpose of this study was to compare the accuracy and precision of the femoral tunnel placement with an offset guide in performing a single-bundle ACL reconstruction through the Anteromedial (AM) portal between expert and novice surgeons.
Methods and Materials
Twenty-five single-bundle ACL reconstructions performed by a novice surgeon were matched with 25 of those by an expert surgeon, following one-to-one propensity score matching. The same technique was used in both groups for femoral tunnel placement with the use of a 7 mm offset guide through the AM portal. Using the Bernard and Hertel grid method on postoperative 3-dimensional reconstructed computed tomography, the accuracies and precisions of the various tunnel positions were compared.
Results
There were no differences found between the proximal-distal and anterior-posterior femoral tunnel placements between the two groups (proximal-distal; 30.5% in expert and 32.5% in novice, p = 0.095) (anterior-posterior; 32.6% in expert and 31.6% in novice, p = 0.410). The accuracies of the femoral tunnel positions, using the average distance from the tunnel center to the center of ACL direct insertion were similar between the two groups (p > 0.05). There were no differences found between the precisions of the femoral tunnel positions between the groups (p > 0.05).
Conclusion
Novice surgeons can have accuracy and precision similar to those of an expert in making femoral tunnels by using a femoral offset guide in single-bundle ACL reconstruction through the AM portal. We recommend the use of a femoral offset guide in the practice of ACL reconstruction during the learning period of a novice surgeon for tunnel placement in order to reduce the learning curve required to perform an accurate and reproducible ACL reconstruction.
