Arthrometric Stability of Horizontal Versus Vertical Single-bundle Arthroscopic Anterior Cruciate Ligament Reconstruction

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Arthrometric Stability of Horizontal Versus Vertical Single-bundle Arthroscopic Anterior Cruciate Ligament Reconstruction

Matteo Denti, MD; Paolo Arrigoni, MD; Piero Volpi, MD; Corrado Bait, MD; Jean Claude Sedran, MD; Pietro Randelli, MD

• Orthopedics
• May 2014 - Volume 37 · Issue 5: 321-324
• DOI: 10.3928/01477447-20140430-05

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Abstract

The anteroposterior (AP) stability of standard anterior cruciate ligament (ACL) reconstruction, referred to as “vertical,” was compared with that of a modified femoral position, referred to as “horizontal,” which is lower than and anterior to an operative knee at 90° flexion. Two consecutive series of 50 patients underwent vertical and horizontal arthroscopic single-bundle ACL reconstruction, respectively. For vertical reconstruction, the clock position was chosen, placing the graft at 10:30 in right knees and 1:30 in left knees, 1 to 2 mm anterior to the posterior femoral cortical cortex and at the back of the resident ridge. In the horizontal reconstruction, the transplant replaced the original ligament insertion at approximately the 9:30 o’clock position in right knees and the 2:30 o’clock position in left knees, approximately 2 mm in front of the posterior femoral cortical cortex. One year after surgery, the results of stabilometric evaluation revealed good performance after horizontal transplant. The mean clinical results changed from 1.0 (±1.3) mm for vertical to 0.7 (±1.3) mm for horizontal reconstruction. [Orthopedics. 2014; 37(5):321–324.]

The authors are from the Knee Surgery and Sports Traumatology Department (MD, PV, CB), IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; the Orthopaedic Clinic Department (PA, PR), University of Milan, Policlinico San Donato, San Donato Milanese, Italy; and the Orthopaedic and Traumatology Department (JCS), Clinica Luganese, Lugano, Switzerland.

The authors have no relevant financial relationships to disclose.

The authors thank Vincenza Ragone for help editing the references.

Correspondence should be addressed to: Paolo Arrigoni, MD, Orthopaedic Clinic Department, University of Milan, Policlinico San Donato, via Morandi 30, San Donato Milanese, 20135 Italy ( arrigoni.p@gmail.com).

Received: July 26, 2013

Accepted: September 05, 2013