THE EFFECTS OF TIBIAL TUNNEL PLACEMENT AND ROOFPLASTY ON RECONSTRUCTED ANTERIOR CRUCIATE LIGAMENT KNEES

Seventy-five anterior cruciate ligament (ACL) reconstructions augmente d with the Kennedy Ligament Augmentation Device were evaluated accordi ng to classification of tibial drill-hole position on the basis of the anatomic landmarks of the ACL by two-dimensional radiographic imaging of the fully extended knee. The effects of roofplasty to avoid graft impingement were also assessed. The tibial drill-hole position was cla ssified in relation to the medial intercondylar tubercle on anterior-p osterior (AP) view, and in relation to Blumensaat' a line (B-line) on lateral view. Arthroscopic evaluation of the ACL and incidence of chro nic synovitis as well as Lysholm knee score, manual knee tests, knee e xtension and flexion angles, and knee tester measurements were perform ed. The results indicated that the knee joints in which the tibial dri ll hole was positioned laterally from the medial intercondylar tubercl e or in which the tibial drill hole was positioned anteriorly to the B -Line showed a tendency to develop more postoperative chronic synoviti s. The knees in which the tibial drill hole was positioned anteriorly to the B-line also showed larger AP laxity. There was no difference be tween the non-roofplasty and roofplasty groups.