J Exp Orthop. 2016 Dec;3(1):37. doi: 10.1186/s40634-016-0073-1. Epub 2016 Dec 12.
Drill wobble - effect on femoral tunnel aperture during anterior cruciate ligament reconstruction.
Journal of experimental orthopaedics
Naser Alnusif, Adam Hart, Maher Baroudi, Robert Marien, Mark Burman, Paul A Martineau
Affiliations
Affiliations
- Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Avenue, A5-175.1, Montreal, QC, H3G 1A4, Canada. [email protected].
- Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Avenue, A5-175.1, Montreal, QC, H3G 1A4, Canada.
PMID: 27957713
PMCID: PMC5153388 DOI: 10.1186/s40634-016-0073-1
Abstract
BACKGROUND: In anterior cruciate ligament reconstruction performed using cortical button fixation on the femur, we have observed a "wobble" effect that can occur when a cannulated femoral drill is used over a guide pin that is not securely fixed in bone. Our study assessed the effect of drill "wobble" on femoral tunnel aperture in sawbones.
METHODS: Femoral tunnels were drilled in sawbones, which had been divided in two groups of 10 each, per drilling technique. The "wobble" technique group had the smaller cortical button drill passed before drilling the graft socket with the bigger diameter femoral drill. In contrast, in the "non-wobble" technique group, the smaller cortical button drill was passed after drilling the graft socket. The aperture dimensions: antero-posterior, proximo-distal and oblique, as well as the length of each tunnel, were measured.
RESULTS: While the average dimensions of the tunnels were similar between the two techniques, there was significantly more variation in the antero-posterior measurements for the wobble technique as compared to the non-wobble technique (mean 7.3 mm, SD 0.28 mm, and mean 7.3 mm, SD 0.11 mm, respectively; Brown-Forsythe test, p 0.02).
CONCLUSION: We conclude that using the "socket first" "non-wobble" technique is a single surgical technical step surgeons can employ to decrease variability in tunnel aperture and size.
Keywords: Anterior cruciate ligament; Anterior cruciate ligament reconstruction failure; Femoral tunnel placement; Wobble effect
References
- Arch Orthop Trauma Surg. 2008 May;128(5):509-13 - PubMed
- Am J Sports Med. 2008 May;36(5):851-60 - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2015 Aug 21;:null - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2005 Mar;13(2):92-100 - PubMed
- J Knee Surg. 2004 Jul;17 (3):127-32 - PubMed
- Clin Orthop Surg. 2012 Dec;4(4):249-55 - PubMed
- Arthroscopy. 2011 Apr;27(4):522-5 - PubMed
- Orthopedics. 2007 Mar;30(3):206-9 - PubMed
- Am J Sports Med. 2008 Apr;36(4):678-85 - PubMed
- Arthroscopy. 2007 Dec;23 (12 ):1326-33 - PubMed
- J Bone Joint Surg Am. 2010 Apr;92 (4):871-81 - PubMed
- Cochrane Database Syst Rev. 2012 Nov 14;11:CD008413 - PubMed
- Arthroscopy. 2007 Nov;23(11):1187-92 - PubMed
- Am J Sports Med. 2007 Oct;35(10):1708-15 - PubMed
- Am J Sports Med. 2002 Sep-Oct;30(5):660-6 - PubMed
- Arthroscopy. 2016 Jan;32(1):34-42 - PubMed
- J Bone Joint Surg Am. 2013 Nov 20;95(22):2029-34 - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2010 Jan;18(1):2-10 - PubMed
- Am J Sports Med. 2010 Jun;38(6):1237-45 - PubMed
- Am J Sports Med. 2005 May;33(5):712-8 - PubMed
- Arthroscopy. 2015 Sep;31(9):1777-83 - PubMed
- Yonsei Med J. 2014 Nov;55(6):1584-91 - PubMed
- Arthroscopy. 2010 Mar;26(3):342-50 - PubMed
- Int Orthop. 2012 Apr;36(4):845-52 - PubMed
- Knee Surg Sports Traumatol Arthrosc. 2000;8(4):207-13 - PubMed
- Arthroscopy. 2012 Aug;28(8):1094-103 - PubMed
- J Bone Joint Surg Am. 2011 Nov 16;93(22):2063-71 - PubMed
- Int J Clin Exp Med. 2015 Sep 15;8(9):14604-14 - PubMed
Publication Types