Optimal Condition to Create Femoral Tunnel Considering Combined Influence of Knee Flexion and Transverse Drill Angle in Anatomical Single-Bundle ACL Reconstruction Using Medial Portal Technique: 3D Simulation Study

Figure 3

The graft bending angle at the femoral tunnel aperture was measured as the angle between the femoral tunnel penetrated by virtual cylinder and the extended line that passed through the tibial footprint center and the femoral footprint center with the knee in full extension. (a) The tibial footprint center was determined according to the following coordinates: the point located at 35.7% of the anterior-to-posterior depth of the tibia measured from the anterior border and at 51.5% of the medial-to-lateral width of the tibia measured from the medial border. (b) Anterior view. (c) Oblique view. Point A is the tibial footprint center, and point B is the femoral footprint center. Extended line that passed through these two centers is the line connecting points A, B, and C. Point D indicates the center of femoral tunnel at the external cortex. The graft bending angle is measured as the angle composed of points C, B, and D.

(a)

(b)

(c)