Three-Dimensional Imaging Validation of a Notch-Based Method for Assessing Mediolateral Tibial Tunnel Placement in Anterior Cruciate Ligament Reconstruction

By
Vu Tu Nam
Vu Duc Thang
Le Duc Huy
Luu Huu Phuc
Luong Nhat Anh
Le Duc Thinh
Chu Hoang Long
Nguyen Ngoc Huyen
Nguyen Duc Trung
Ta Van Thanh Nam
Ho Ngoc Minh
Tran Trung Dung
October 13, 2026

Archives Of Orthopaedic And Trauma Surgery

At a Glance

Category	Detail
Condition	Clinical topic addressed by the source article: Three-Dimensional Imaging Validation of a Notch-Based Method for Assessing Mediolateral Tibial Tunnel Placement in Anterior Cruciate Ligament Reconstruction
Key Mechanisms	Mechanisms or clinical associations described in the source article.
Target Population	Adults aged 18 years or older undergoing primary ACL reconstruction with a standardized arthroscopic all-inside single-bundle technique incorporating NRML verification; exclusions included prior surgery on the affected knee, multiligament injury, or imaging inadequate for measurement.
Care Setting	Care setting described in the source article.

Key Highlights

The study evaluated NRML verification by comparing postoperative 3D CT tibial tunnel-center location with the native footprint center measured on preoperative 3D MRI.
The technique was developed to address the difficulty of identifying a consistent bony landmark for mediolateral tibial tunnel placement.
The study was a single-institution retrospective cross-sectional study of consecutive primary ACL reconstructions performed from January 2024 through December 2025.
The supplied excerpt describes the study rationale and methods but does not report results.

Guideline-Based Recommendations

Diagnosis

Management

Monitoring & Follow-up

Risks

The article identifies non-anatomic tunnel placement as a major technical factor in ACL reconstruction failure, occurring in as many as 77% of revision cases.
The article states that inaccurate graft placement can contribute to abnormal graft loading, impingement, and elongation risk.
The article states that chronic ACL deficiency may leave the ligament remnant absent, displaced, or scarred, limiting its usefulness as a reference for tunnel placement.

Patient & Prescribing Data

Adults aged 18 years or older undergoing primary ACL reconstruction; exclusions included prior surgery on the affected knee, multiligament injury, or imaging inadequate for measurement.

The study evaluated a standardized arthroscopic all-inside single-bundle ACL reconstruction incorporating NRML verification. The excerpt provides no medication or prescribing information.