The lateral tibial tunnel : Does it allow for adequate fixation in ACL surgery ?


Published online: Oct 27 2012

Hans VAN DER BRACHT, Garth CLOETE, Benedict PAGE, Cornie SCHEFFER, Johan BELLEMANS, Peter VERDONK

From UZ, Gent and GZA Sint Augustinus, Antwerpen, Belgium

Abstract

The purpose of this cadaver study about the ACL graft was to compare a “Lateral Tibial Tunnel” (LTT) and a “classic, anteroMedial Tibial Tunnel” (MTT), as to fixation strength and mode of failure. Ten pairs of fresh frozen human proximal tibias were used. In one of both tibias a classic anteromedial tunnel was used, versus a lateral tibial tunnel in the contralateral knee. Autologous doubled semitendinosus and gracilis tendons were fixed in the tunnels. A maximum load to failure test was performed to determine the stiffness and the strength of the graft-tibia complex. Conclusion : for none of the measurements was there any significant difference between both tunnels. The tibial fixation strength of a human autologous doubled hamstring graft in ACL surgery is similar, whether a lateral or an anteromedial tibial tunnel is used. This is the first study investigating fixation strength of an ACL graft in a lateral tibial tunnel.