Iatrogenic lateral meniscus anterior horn injury in different tibial tunnel placement techniques in ACL reconstruction surgery e A cadaveric study

Abstract

Objectives: The aim of this study was to analyze the effect of tibial tunnel positioning in single bundleand double bundle ACL reconstructions on lateral meniscus anterior root.Materials: Twelve single knee cadavers were used, 6 for a single bundle ACL reconstruction, which werereamed gradually starting from 8 mm, 9 mm and ended with a 10 mm reamers, while the other 6 wereprepared for a double bundle ACL reconstruction in which 7 mm reamer for the AM tunnel and 6 mmreamer for the PL tunnel were used. After drilling, changes of lengths and thicknesses of anterior horns ofthe lateral menisci were recorded.Results: Before drilling, the groups were homogenous for the lateral menisci dimensions. After drilling,no statistically signiŞcant difference was noticed between the two groups. However, in single bundlegroup, 2 anterior horns width injury (1.44 mm and 2.13 mm) with the 9 mm reamer and 3 anterior hornswidth injury (2.51 mm, 3.55 mm and 4.28 mm) with the 10 mm reamer were recorded. However indouble bundle group a single anterior horn width injury (2.82 mm) was recorded.Conclusion: Using a greater size reamer in single bundle reconstruction, causes a relatively higher risk oflateral meniscal anterior root injury. Lateral meniscus stability should be examined arthroscopically afterreaming with large reamers.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).