LATERAL. Angles. Intersecting. Mean Values. Minimum Angle. Mean Values. Maximum Angle. Right Knee. 0° to 85°. 18,85 ± 15,60°. 62,69 ± 10,98°. Left Knee.
MRI Pre operative planning of tibial tunneling in Posterior Cruciate Ligament reconstruction Robson Souza, MD; João Espregueira, MD PhD; Franklin Cajaíba, PT ; Abner Portugal, PT; George Neves, MD.
MRI Pre operative planning of tibial tunneling in Posterior Cruciate Ligament reconstruction Robson Souza, MD I have no financial conflicts to disclose.
Introduction
Posterior Cruciate Ligament (PCL) injuries may lead to functional disability; • Surgical repair is at times indicated; Special care must be taken during surgical reconstruction to avoid injury during tibial tunneling; MRI is an excellent tool for diagnosis and anatomical evaluation of these structures.
Objectives This study sought to use MRI to identify the anatomical position of the neurovascular bundle and measure safe angles for the tibial tunneling during PCL reconstruction.
Materials and Methods
Observational study;
200 MRI (100 from each knee in extension) - evalueted distance and angles; • Distance from 200 MRI only extension (PCL insertion and the neurovascular bundle); • 20 MRIs were also evaluated
Extension Knee
with the knee at 90° flexion evalueted ditance.
Flexion Knee
Materials and Methods Angles of tunnels • Delineated imaginary 10mm tunnels centered on the PCL insertion point.
MEDIAL to LATERAL
LATERAL to MEDIAL
All images were obtained using the same equipment and all measurements were verified by a single evaluator.
Results Intersection of the angles MEDIAL to LATERAL
Angles Intersecting
Mean Values Minimum Angle
Mean Values Maximum Angle
Right Knee
0° to 85°
18,85 ± 15,60°
62,69 ± 10,98°
Left Knee
0° to 85°
21,85 ± 17,34°
60,8 ± 11,69°
LATERAL to MEDIAL
Angles Intersecting
Mean Values Minimum Angle
Mean Values Maximum Angle
Right Knee
0° to 60°
0.0 ± 0,0°
14,15 ± 15,46°
Left Knee
0° to 45°
0,1 ± 1,0°
13,80 ± 13,91°
Results The distance between the neurovascular bundle and the insertion of the PCL • 200 MRI Extension Right Knee
1,19 ± 0,31cm
Left Knee
1,22± 0,34cm
• Soubgroup of 20 MRI Extension
Flexion
p Value
Right Knee
1,31 ± 0,27cm
1,85 ± 0,50cm
p
