Intraosseous Femoral Tunnel Morphometry of the Distal Femur: Correlation between Tunnel Angle and Tunnel Length following Arthroscopic Anterior Cruciate Ligament Reconstruction.
Year: 2026
Type: article
Abstract: Introduction: The creation of the femoral tunnel is one of the most anatomically demanding steps in an arthroscopic anterior cruciate ligament (ACL) reconstruction. The placement of the femoral tunnel in the distal femur has a role to play in the geometry of the tunnel and in the characteristics of the fixation, its trajectory, and the length of the intraosseous tunnel. The femoral tunnel angle and the tunnel length have been studied separately in ACL reconstruction. However, the literature is limited on the anatomical relationship of these two factors in the distal femur through combined radiographic and computed tomography (CT) assessment. Objectives: To determine the degree of relationship of the femoral tunnel angle with the intraosseous femoral tunnel length post-arthroscopic ACL reconstruction. Materials and Methods: This observational radiological study involves 70 patients who underwent arthroscopic single-bundle ACL reconstruction using quadrupled hamstring autograft. All patients underwent post-operative radiography and CT scans. Post-operative radiographs were used to measure the femoral tunnel angle using the femoral tunnel axis and distal femoral anatomical reference line. The length of the femoral tunnel was measured using CT multiplanar reconstruction. Tunnel angle and length correlation analysis was performed using the Pearson correlation coefficient. Results: There was a substantial association between the femoral tunnel angle and the length of the intraosseous femoral tunnel. The study findings revealed that the morphology of distal femoral bone influenced femoral tunnel geometry. Conclusion: There are measurable anatomical relationships between femoral tunnel angle and intraosseous tunnel length of the ACL-reconstructed tunnel. Research indicates that the geometry of the femoral tunnel is a reflection of the osseous architecture of the distal femur. Gaining insight into this relationship may help surgeons in achieving an adequate tunnel length with maintenance of cortical integrity through anatomical tunnel placement.
Source: PubMed
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225588678
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