Tibial Tunnel Aperture Irregularity Following Drilling with Five Different Reamer Designs: a Qualitative Micro-CT Analysis

INTRODUCTION: Historically, tibial tunnel creation in ACL reconstruction was performed by antegrade insertion of a tibial guide pin followed by antegrade reaming from the anteromedial tibial metaphysis (distal aperture) to the tibial plateau (proximal aperture). In the last few years retrograde reaming has been introduced.[1, 2] It has been theorized that the retrograde tibial tunnel drilling technique may cause less trauma to the proximal aperture.[3] Our hypothesis was that the proximal and distal apertures of ACL tibial tunnels created with different reamers would be affected by the type of reamer design. The purpose of this study was to compare the potential differences between antegrade and retrograde reaming using different reamer designs and the effect on both proximal and distal tibial tunnel apertures using micro-computed tomography (micro-CT).