Further, a corrective factor is introduced for oblique sensor placement relative to the fire front, in order to improve the value of these and other measurements, particularly for model comparison.
[33], performing ACL reconstruction with a TT technique, reported that, in a subset of patients with vertical graft orientation, clinical examination (pivot shift, KT-1000 measurements) and Lysholm score were significantly worse in comparison with patients with a more oblique graft placement.
They concluded that in a severely osteoporotic model, failure in cantilever bending at low forces would take place regardless of fixation methods used and the added benefit of oblique screw placement observed in healthy bone is not observed in osteoporotic bone.
Statistical analysis showed a significant difference between the two groups in femoral tunnel obliquity in coronal plane (p = 0.009), with a more oblique femoral tunnel placement registered in group B.
Thus, a more oblique femoral tunnel placement can be achieved, without the constraint of a guide through the tibial tunnel, limiting posterior tunnel blowout and shorter tunnel length, as knee flexion is not determinant for good visualization of the ACL femoral footprint.
According to biomechanical studies, oblique femoral tunnel placement in coronal plane results in better restoration of normal knee kinematics and improvement of rotator knee stability in comparison with a more vertical tunnel [10, 11] with no differences under combined rotary loads between double-bundle reconstruction and laterally placed single-bundle reconstruction [32].
The tube was placed tangential through the abdominal wall, thus penetrating the abdominal rectus muscle and the oblique muscles before placement of the other end in the subcutaneous tissue, immediately under the skin, and sutured with 4-0 nylon to stay in place (Ethilon, Ethicon, Johnson & Johnson, Sweden) and 1(h)).
Peroneal nerve palsy may also be associated with the placement of oblique locking screws [21].
Ultrasound-guided oblique intercostal approach for catheter placement and infusions of dilute ropivicaine for 4-5 days.
The OI technique seems to be a good option for single-bundle ACL reconstruction, when more oblique and anatomical femoral tunnel placement is desired to reduce the risk of short tunnel or posterior blowout.
