Intraosseous Femoral Tunnel Morphometry of the Distal Femur: Correlation between Tunnel Angle and Tunnel Length following Arthroscopic Anterior Cruciate Ligament Reconstruction
Abstract
Introduction: The creation of the femoral tunnel is one of the most anatomically demanding steps in an arthroscopic anterior cruciate ligament (ACL) reconstruction. The placement of the femoral tunnel in the distal femur has a role to play in the geometry of the tunnel and in the characteristics of the fixation, its trajectory, and the length of the intraosseous tunnel. The femoral tunnel angle and the tunnel length have been studied separately in ACL reconstruction. However, the literature is limited on the anatomical relationship of these two factors in the distal femur through combined radiographic and computed tomography (CT) assessment. Objectives: To determine the degree of relationship of the femoral tunnel angle with the intraosseous femoral tunnel length post-arthroscopic ACL reconstruction. Materials and Methods: This observational radiological study involves 70 patients who underwent arthroscopic single-bundle ACL reconstruction using quadrupled hamstring autograft. All patients underwent post-operative radiography and CT scans. Post-operative radiographs were used to measure the femoral tunnel angle using the femoral tunnel axis and distal femoral anatomical reference line. The length of the femoral tunnel was measured using CT multiplanar reconstruction. Tunnel angle and length correlation analysis was performed using the Pearson correlation coefficient. Results: There was a substantial association between the femoral tunnel angle and the length of the intraosseous femoral tunnel. The study findings revealed that the morphology of distal femoral bone influenced femoral tunnel geometry. Conclusion: There are measurable anatomical relationships between femoral tunnel angle and intraosseous tunnel length of the ACL-reconstructed tunnel. Research indicates that the geometry of the femoral tunnel is a reflection of the osseous architecture of the distal femur. Gaining insight into this relationship may help surgeons in achieving an adequate tunnel length with maintenance of cortical integrity through anatomical tunnel placement.
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BibTeX
@article{rajadurai2026intraosseous,
title = {{Intraosseous Femoral Tunnel Morphometry of the Distal Femur: Correlation between Tunnel Angle and Tunnel Length following Arthroscopic Anterior Cruciate Ligament Reconstruction}},
author = {Jeff Walter OR Rajadurai and Sravya Bellamkonda and T Saminathan and Ram Kumar and M Sathesh Kumar and K Purushothaman},
journal = {Journal of Orthopaedic Case Reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8544},
url = {https://doi.org/10.13107/jocr.2026.v16.i11.8544},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Intraosseous Femoral Tunnel Morphometry of the Distal Femur: Correlation between Tunnel Angle and Tunnel Length following Arthroscopic Anterior Cruciate Ligament Reconstruction
AU - Jeff Walter OR Rajadurai
AU - Sravya Bellamkonda
AU - T Saminathan
AU - Ram Kumar
AU - M Sathesh Kumar
AU - K Purushothaman
PY - 2026
DA - 2026/11/09
JO - Journal of Orthopaedic Case Reports
DO - 10.13107/jocr.2026.v16.i11.8544
UR - https://doi.org/10.13107/jocr.2026.v16.i11.8544
AB - Introduction: The creation of the femoral tunnel is one of the most anatomically demanding steps in an arthroscopic anterior cruciate ligament (ACL) reconstruction. The placement of the femoral tunnel in the distal femur has a role to play in the geometry of the tunnel and in the characteristics of the fixation, its trajectory, and the length of the intraosseous tunnel. The femoral tunnel angle and the tunnel length have been studied separately in ACL reconstruction. However, the literature is limited on the anatomical relationship of these two factors in the distal femur through combined radiographic and computed tomography (CT) assessment. Objectives: To determine the degree of relationship of the femoral tunnel angle with the intraosseous femoral tunnel length post-arthroscopic ACL reconstruction. Materials and Methods: This observational radiological study involves 70 patients who underwent arthroscopic single-bundle ACL reconstruction using quadrupled hamstring autograft. All patients underwent post-operative radiography and CT scans. Post-operative radiographs were used to measure the femoral tunnel angle using the femoral tunnel axis and distal femoral anatomical reference line. The length of the femoral tunnel was measured using CT multiplanar reconstruction. Tunnel angle and length correlation analysis was performed using the Pearson correlation coefficient. Results: There was a substantial association between the femoral tunnel angle and the length of the intraosseous femoral tunnel. The study findings revealed that the morphology of distal femoral bone influenced femoral tunnel geometry. Conclusion: There are measurable anatomical relationships between femoral tunnel angle and intraosseous tunnel length of the ACL-reconstructed tunnel. Research indicates that the geometry of the femoral tunnel is a reflection of the osseous architecture of the distal femur. Gaining insight into this relationship may help surgeons in achieving an adequate tunnel length with maintenance of cortical integrity through anatomical tunnel placement.
SN - 2250-0685
SN - 2321-3817
ER -