Iatrogenic Lateral Meniscus Anterior Horn Injury in Different Tibial Tunnel Placement Techniques in ACL Reconstruction Surgery - A Cadaveric Study

Abstract

Objectives: lateral meniscus anterior root origin is close to the ACL insertion, it can be injured with ACL reconstruction. The purpose of this study was to identify the effect of tibial tunnel positioning of single bundle and double bundle ACL reconstructions on lateral meniscus anterior root.
Materials: 12 single knee cadavers were used, 6 for a single bundle ACL reconstruction, which were reamed gradually starting from 8 mm, 9 mm and ended with a 10 mm reamers, while the other 6 were prepared for a double bundle ACL reconstruction in which 7 mm reamer for the AM tunnel and 6 mm reamer for the PL tunnel were used.  After drilling, changes of lengths and thicknesses of  anterior horns of the lateral menisci were recorded.
Results: Before drilling, both groups didn't show any statistical significance. After drilling, no statistically significant difference noticed between the two groups. However, In a single bundle tunnel group, 2 anterior horns width injury (1,44 mm and 2,13 mm) with the 9 mm reamer whereas 3  anterior horns width injury (2,51mm, 3,55mm and 4,28mm) with the 10 mm reamer were recorded. However with a double bundle tunnel group a single anterior horn width injury (2,82 mm) was recorded.
Conclusions: Using a greater size reamer in single tunnel reconstruction, causes a relatively higher risk of lateral anterior meniscal root injury. Lateral meniscus stability should be examined arthroscopically after reaming with large reamers. Further studies should be conducted to evaluate the biomechanical impact of such injuries on meniscal stability.

 

DOI: 10.3944/AOTT.2016.15.0340
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Keywords

• ACL Reconstruction; lateral Meniscus; Anterior horn injury.