caa a22 4500 605457816 CHVBK 20210128100225.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00167-013-2770-y doi (NATIONALLICENCE)springer-10.1007/s00167-013-2770-y Influence of tibial rotation on tibial tunnel position measurements using lateral fluoroscopy in anterior cruciate ligament reconstruction [Elektronische Daten] [Carl Haasper, Sebastian Kopf, Stephan Lorenz, Kellie Middleton, Scott Tashman, Freddie Fu] Purpose: The purpose of the current study was to evaluate the influence of internal and external knee rotation on tibial tunnel position measurements in anterior cruciate ligament reconstruction using the Amis and Jakob line. Methods: Anatomic double bundle ACL reconstruction was performed in seven cadaveric knees. Afterwards, the knees were CT scanned, and 3D CT models were established. Utilizing these models, strict lateral and radiographs with the knees in 5°, 10°, and 20° of internal as well as external rotation were established. Using these radiographs, the positions of the anteromedial (AM) and posterolateral (PL) tibial tunnels were measured using the Amis and Jacob line. The tunnel positions of the strict lateral were compared to the rotated radiographs. To assess the inter- and intraobserver reliability, two independent observers measured the tunnel positions, and one observer measured twice. Results: Significant differences for the AM tunnel position were observed if more than 10° of external or 20° of internal rotation were applied. For the PL tunnel position, no significant differences were found between the strict lateral and the rotated radiographs. Inter- and intraobserver reliability was good. Conclusions: The accuracy of the Amis and Jakob line is dependent on the degree of knee rotation and the position of the measured tunnel. Therefore, when using the Amis and Jakob line to determine the tibial tunnel position during surgery, attention should be paid to rotational alignment of lateral radiographs. However, the maximum rotation tested in the present study (20°) showed only a difference in tunnel position of 3.3% compared to optimal rotational alignment. Thus, in most cases, the effects of minor malrotation on tunnel position measurement should be of minimal clinical significance. Level of evidence: Diagnostic study. Springer-Verlag Berlin Heidelberg, 2013 Anatomic nationallicence Tibial tunnel position nationallicence Tibial insertion nationallicence Radiograph nationallicence X-ray image nationallicence Haasper Carl Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Kopf Sebastian Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Lorenz Stephan Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Middleton Kellie Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Tashman Scott Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Fu Freddie Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/3(2015-03-01), 649-654 0942-2056 23:3<649 2015 23 167 https://doi.org/10.1007/s00167-013-2770-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2770-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Haasper Carl Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Kopf Sebastian Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Lorenz Stephan Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Middleton Kellie Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Tashman Scott Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Fu Freddie Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/3(2015-03-01), 649-654 0942-2056 23:3<649 2015 23 167