Relevant bibliographies by topics / Tunnel placement

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  2. Dissertations / Theses
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Academic literature on the topic 'Tunnel placement'

Author: Grafiati
Published: 19 February 2023

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Journal articles on the topic "Tunnel placement"

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Cain, E., Marcus Biggers, Benton Emblom, Jeffrey Dugas, and David Beason. "Comparison of Anterior Cruciate Ligament Graft Isometry between Paired Femoral and Tibial Tunnels." Journal of Knee Surgery 30, no. 09 (March 10, 2017): 960–64. http://dx.doi.org/10.1055/s-0037-1599251.

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AbstractAccurate tunnel placement is important for a successful anterior cruciate ligament (ACL) reconstruction. Controversy exists concerning the preferred method of femoral tunnel preparation, with proponents of both medial portal and transtibial drilling techniques. Current ACL literature suggests that placement of the femoral ACL attachment site posterior or “low” in the ACL footprint leads to more anatomically correct ACL mechanics and better rotational control. There is limited literature focusing on ACL graft displacement through knee range of motion based on specific paired placement of femoral and tibial tunnels. Our purpose was to assess ACL isometry between multiple combinations of femoral and tibial tunnels. We hypothesized that placement of the graft at the posterior aspect of the ACL footprint on the femur would be significantly less isometric and lead to more graft displacement as compared with central or anterior placement. The ACL of matched pairs of cadaveric knees was arthroscopically debrided while leaving the soft tissue footprint on the femur and tibia intact. One knee from each pair underwent notchplasty. In all knees, three femoral and three tibial tunnels were created at the anterior, central, and posterior aspects of the ACL footprint. A suture was passed through each tunnel combination (nine potential pairs), and the change in isometry was measured throughout full knee range of motion. Placement of the femoral tunnel along the posterior aspect of the ACL footprint was less isometric compared with a central or anterior position in the femoral footprint. Placement of a posterior tibial tunnel also led to decreased isometry, but tibial tunnel placement affected isometry to a lesser extent than femoral tunnel placement. The combination of a posterior femoral and posterior tibial tunnel resulted in greater than 1 cm of graft excursion from full flexion to extension. Placement of ACL tunnels at anisometric sites may adversely affect the mechanical properties and behavior of the ACL graft, resulting in either graft laxity in flexion or overconstraint and loss of extension.
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Parker, David A., Samuel Grasso, Corey Scholes, Brett Fritsch, and Qing Li. "Quantitative MRI Evaluation of Tunnel placement in ACL Reconstruction." Orthopaedic Journal of Sports Medicine 5, no. 5_suppl5 (May 1, 2017): 2325967117S0018. http://dx.doi.org/10.1177/2325967117s00180.

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Introduction: Positioning of the graft ACL in the native footprint center is important to replicate the anatomy and function of the ACL for each individual patient. It is known that incorrect bone tunnel placement for the reconstructed ligament is a contributor to poor clinical outcomes postoperatively. Currently the success of tunnel placement is determined by training and experience of the treating surgeon and there is no universally accepted quantifiable and objective method to evaluate the execution of these decisions. The goal of this project was to develop a quantitative routine assessment to assist pre-surgical planning and also evaluate the execution of femoral and tibial bone tunnel placement in ACL reconstructed knees. Methods: The study recruited failed primary ACL reconstructed patients (N=25) who consented to undergo revision ACL reconstruction to establish the placement of the graft ACL tunnel apertures in the femur and tibia. Prior to surgery each participant underwent high resolution 3 T MRI of their injured knee and 3D models were generated through segmentation of soft and hard tissue knee structures. During surgery previous graft tunnels and prominent reference landmarks visible on MRI and arthroscopically were registered using intraoperative navigation to act as the reference standard. The placement of the tunnel apertures in the femur and tibia were measured in all three planes using a novel measurement method. Results: Preliminary result show that the measurement method can assess the placement of tunnel apertures in the femur and tibia within 0.1 – 1.0 mm of the intraoperative data, using reference landmarks identifiable in MRI and arthroscopically. Additionally, the area of the tunnel aperture, bone tunnel volume can be evaluated. Reliability and validation of the novel method is ongoing using medical imaging and intraoperative navigation to register the placement of bone tunnels in revision ACL reconstruction patients. Conclusions: Correct placement of graft ACL bone tunnels inside the native ACL footprint is critical to the outcome of ACL reconstruction. Development of an accurate reproducible method for assessment of tunnel placement relative to the anatomical footprint should provide a simple method for objectively assessing ACL reconstructions. Preliminary results of this routine assessment suggests that graft tunnel placement can be objectively assessed to assist clinicians to evaluate and improve ACL reconstruction technique and evaluation of ACL reconstruction outcomes.
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Ekdahl, Max, Masahiro Nozaki, Mario Ferretti, Andrew Tsai, Patrick Smolinski, and Freddie H. Fu. "The Effect of Tunnel Placement on Bone-Tendon Healing in Anterior Cruciate Ligament Reconstruction in a Goat Model." American Journal of Sports Medicine 37, no. 8 (June 9, 2009): 1522–30. http://dx.doi.org/10.1177/0363546509332503.

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Background Misplacement of the bone tunnels is one of the main causes of graft failure of anterior cruciate ligament surgery. Hypothesis Anatomic tunnel placement in anterior cruciate ligament surgery reconstruction will lead to improved outcomes, including biological ingrowth and biomechanical properties, when compared with nonanatomic tunnel placement. Study Design Controlled laboratory study. Methods Anterior cruciate ligament surgery reconstructions were performed on 3 different groups of goats (1 anatomic tunnel placement group and 2 different nonanatomic tunnel placement groups, with 10 goats in each group). For each group of 10 knees, 3 knees were used for histologic evaluation (bone tunnel enlargement, number of osteoclasts at the bone tendon interface, and revascularization of the graft) and 7 knees were used for biomechanical testing (anterior tibial translation, in situ force, cross-sectional area, and ultimate failure load). Animals were sacrificed at 12 weeks after surgery. Results The anatomic tunnel placement group showed less tunnel enlargement on the tibial side, fewer osteoclasts on both the tibial and femoral sides, and more vascularity in the femoral side when compared with the 2 nonanatomic reconstruction groups. Biomechanically, the anatomic tunnel placement group demonstrated less anterior tibial translation and greater in situ force than both nonanatomic tunnel placement groups. Conclusion Anatomic tunnel placement leads to superior biological healing and biomechanical properties compared with nonanatomic placement at 12 weeks after anterior cruciate ligament surgery reconstruction in a goat model. Clinical Relevance The findings of this study demonstrate the importance of anatomic tunnel placement in anterior cruciate ligament surgery reconstruction.
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Hiemstra, Laurie, Catherine O'Brien, Mark Lafave, and Sarah Kerslake. "Accuracy and Learning Curve of Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction." Journal of Knee Surgery 30, no. 09 (February 13, 2017): 879–86. http://dx.doi.org/10.1055/s-0037-1598175.

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AbstractThe purpose of this study was to assess the accuracy of femoral tunnel placement in a medial patellofemoral ligament reconstruction (MPFL-R) cohort. The secondary purpose was to establish the evidence of a learning curve to achieve acceptable femoral tunnel placement during MPFL-R. Two surgeons, using lateral radiographs, assessed 73 subjects post–MPFL-R. Femoral tunnel accuracy and direction of tunnel error were measured in relation to Schöttle's point (A–T distance). Interrater reliability (intraclass correlation coefficient 2,k) of these measures was calculated. Learning curve of accurate femoral tunnel placement was examined by dividing the patient cohort into quartiles. A one-way analysis of variance was used to assess the quartiles for accuracy of femoral tunnel position and surgical time. In relation to Schöttle's point, 66/73 (90.4%) femoral tunnels were categorized as being in a “good” or “excellent” position and 7/73 (9.6%) were categorized as being in a “poor” position. Evidence of an MPFL-R learning curve was established via a statistically significant difference in the mean A to T distance for the four quartiles (F [3, 69] = 6.41, p = 0.001). There was also a statistically significant difference in the surgical time for the four quartiles (F [3, 69] = 8.71, p = 0.001). In this series, accurate femoral tunnels were placed more than 90% of the time during MPFL-R. A clear learning curve for accurate femoral tunnel placement was demonstrated both with respect to distance of the tunnel from Schöttle point and with regard to surgical time. Level of evidence was IV.
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Buscayret, Florent, Eduardo Frois Temponi, Adnan Saithna, Mathieu Thaunat, and Bertrand Sonnery-Cottet. "Three-Dimensional CT Evaluation of Tunnel Positioning in ACL Reconstruction Using the Single Anteromedial Bundle Biological Augmentation (SAMBBA) Technique." Orthopaedic Journal of Sports Medicine 5, no. 5 (May 1, 2017): 232596711770651. http://dx.doi.org/10.1177/2325967117706511.

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Background: Remnant preservation may confer important advantages in the anterior cruciate ligament (ACL)–reconstructed knee. However, the presence of a large remnant may obscure visualization and impair the ability to correctly place tunnels during surgery. Purpose: To determine whether tunnel placement during anatomic ACL reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique is consistent and precise when a large native remnant is preserved. Study Design: Case series; Level of evidence, 4. Methods: Included in this study were 99 patients undergoing an ACL reconstruction during which at least 50% of the native ACL was preserved. The femoral tunnel was created using an outside-in specific guide. The tibial tunnel was positioned in the anteromedial region of the ACL footprint, and the remnant was carefully preserved while drilling and passing the semitendinosus graft through it. Postoperatively, 3-dimensional computed tomography (3D CT) was used to evaluate tunnel placement. The mean tunnel locations were calculated and the standard deviation was used to evaluate precision of positioning. Inter- and intrareader agreement were determined to assess reliability of evaluation of tunnel position. Results: The center of the femoral tunnel was positioned at a mean 19.4% (SD, 2%) of the depth of the notch and a mean 23.1% (SD, 3.5%) of the lateral wall height. The center of the tibial tunnel was positioned at a mean 36.3% (SD, 3.8%) of the anteroposterior length of the tibial plateau and at a mean 47.0% (SD, 2.7%) of the mediolateral width. The small standard deviations demonstrate that this technique allows precise tunnel placement. The tunnel positions achieved were consistent with previous anatomic studies of femoral and tibial anteromedial bundle insertion. Intra- and interobserver reliability were high. Conclusion: Three-dimensional CT evaluation demonstrated that despite the presence of a large remnant, placement of femoral and tibial tunnels for anatomic ACL reconstruction using the SAMBBA technique is consistent and precise.
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Perry, Allison, Alex Brady, Navya Dandu, Harsh Singh, Amar Vadhera, Adam Yanke, Robert LaPrade, Jorge Chahla, and Safa Gursoy. "Paper 17: Optimal Tibial Tunnel Placement for Medial and Lateral Meniscal Root Repair in the Setting of Multiligament Reconstructions of the Knee." Orthopaedic Journal of Sports Medicine 10, no. 5_suppl3 (May 1, 2022): 2325967121S0055. http://dx.doi.org/10.1177/2325967121s00555.

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Objectives: Although the risk of tibial tunnel convergence in the setting of multiligament reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), and medial and lateral meniscal root repair has not been defined. The purpose of this study was to examine the risk of tunnel convergence and to determine optimal tunnel placement for ACL and PCL reconstruction performed in conjunction with posterior medial and lateral meniscal root repairs in the proximal tibia. Methods: Three-dimensional tibial models were created using computed tomography scans of twenty cadaveric specimens. After determining optimal tunnel entry and exit points for ACL and PCL reconstructions, and medial and lateral meniscal root repair on the models, Mimics software was used to create root tunnels. The meniscal root repair tunnels were then re-oriented to be parallel to the ACL tunnel. The initial and re-oriented configurations are illustrated in Figure 1. Tunnel convergence risk was analyzed with single and double tunnel techniques in both case scenarios. Results: There were no cases of convergence between the ACL and medial meniscal root tunnels in any of the configurations. The greatest distance between the tunnels was achieved with the single tunnel technique in parallel orientation (12.09 ± 2.78 mm). All specimens demonstrated convergence between the ACL and lateral meniscal root tunnels when the sagittal plane entry was not taken into consideration and only the anatomic root attachment was accounted for, for single and double tunnel techniques, but no convergence was seen between these tunnels with the parallel orientation in the sagittal plane. Figure 2 illustrates the reduction in the convergence risk when the meniscal root tunnels are reoriented as parallel to the ACL tunnel. There were no cases of convergence between the PCL and medial meniscal root tunnels in the original orientation, but 2/20 specimens demonstrated convergence in the parallel orientation with the double tunnel technique and no cases of convergence in the single tunnel technique. The PCL and lateral meniscal root tunnels did not demonstrate convergence in any configuration. Table 1 demonstrates the mean, minimum and maximum distances of each tunnel configuration as well as the number of cases where the distance between tunnels was <2mm. A summary of the preferred tunnel configurations for each setting, ranked by greatest tunnel distance conferred and cases of convergence, is reported in Table 2. Conclusions: There is a high risk of convergence between ACL and posterior meniscus root tunnels. Re-orienting meniscal root tunnels parallel to ACL tunnels may help reduce this risk. When PCL reconstruction is performed with ACL reconstruction and medial and lateral meniscal root repair, the single tunnel root repair technique may pose less risk over the double tunnel technique to prevent tunnel convergence between the meniscal root repair and PCL tunnels in the tibia. [Figure: see text]
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Yoon, Kyoung Ho, Jung-Suk Kim, Jae-Young Park, Soo Yeon Park, Raymond Yeak Dieu Kiat, and Sang-Gyun Kim. "Comparable Clinical and Radiologic Outcomes Between an Anatomic Tunnel and a Low Tibial Tunnel in Remnant-Preserving Posterior Cruciate Ligament Reconstruction." Orthopaedic Journal of Sports Medicine 9, no. 2 (February 1, 2021): 232596712098515. http://dx.doi.org/10.1177/2325967120985153.

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Background: There is currently no consensus on the optimal placement of the tibial tunnel for remnant-preserving posterior cruciate ligament (PCL) reconstruction. Purpose/Hypothesis: The purpose of this study was to compare the clinical and radiologic outcomes of remnant-preserving PCL reconstruction using anatomic versus low tibial tunnels. We hypothesized that the outcomes of low tibial tunnel placement would be superior to those of anatomic tibial tunnel placement at the 2-year follow-up after remnant-preserving PCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed the data for patients who underwent remnant-preserving PCL reconstruction between March 2011 and January 2018 with a minimum follow-up of 2 years (N = 63). On the basis of the tibial tunnel position on postoperative computed tomography, the patients were divided into those with anatomic placement (group A; n = 31) and those with low tunnel placement (group L; n = 32). Clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity level), range of motion, complications, and stability test outcomes at follow-up were compared between the 2 groups. Graft signal on 1-year follow-up magnetic resonance imaging scans was compared between 22 patients in group A and 17 patients in group L. Results: There were no significant differences between groups regarding clinical scores or incidence of complications, no between-group differences in posterior drawer test results, and no side-to-side difference on Telos stress radiographs (5.2 ± 2.9 mm in group A vs 5.1 ± 2.8 mm in group L; P = .900). Postoperative 1-year follow-up magnetic resonance imaging scans showed excellent graft healing in both groups, with no significant difference between them. Conclusion: The clinical and radiologic outcomes and complication rate were comparable between anatomic tunnel placement and low tibial tunnel placement at 2-year follow-up after remnant-preserving PCL reconstruction. The findings of this study suggest that both tibial tunnel positions are clinically feasible for remnant-preserving PCL reconstruction.
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Cook, Jay B., James S. Shaha, Douglas J. Rowles, Craig R. Bottoni, Steven H. Shaha, and John M. Tokish. "Clavicular Bone Tunnel Malposition Leads to Early Failures in Coracoclavicular Ligament Reconstructions." American Journal of Sports Medicine 41, no. 1 (November 8, 2012): 142–48. http://dx.doi.org/10.1177/0363546512465591.

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Background: Modern techniques for the treatment of acromioclavicular (AC) joint dislocations have largely centered on free tendon graft reconstructions. Recent biomechanical studies have demonstrated that an anatomic reconstruction with 2 clavicular bone tunnels more closely matches the properties of native coracoclavicular (CC) ligaments than more traditional techniques. No study has analyzed tunnel position in regard to risk of early failure. Purpose: To evaluate the effect of clavicular tunnel position in CC ligament reconstruction as a risk of early failure. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review was performed of a consecutive series of CC ligament reconstructions performed with 2 clavicular bone tunnels and a free tendon graft. The population was largely a young, active-duty military group of patients. Radiographs were analyzed for the maintenance of reduction and location of clavicular bone tunnels using a picture archiving and communication system. The distance from the lateral border of the clavicle to the center of each bone tunnel was divided by the total clavicular length to establish a ratio. Medical records were reviewed for operative details and functional outcome. Failure was defined as loss of intraoperative reduction. Results: The overall failure rate was 28.6% (8/28) at an average of 7.4 weeks postoperatively. Comparison of bone tunnel position showed that medialized bone tunnels were a significant predictor for early loss of reduction for the conoid (a ratio of 0.292 vs 0.248; P = .012) and trapezoid bone tunnels (a ratio of 0.171 vs 0.128; P = .004); this correlated to an average of 7 to 9 mm more medial in the reconstructions that failed. Reconstructions performed with a conoid ratio of ≥0.30 were significantly more likely to fail (5/5, 100%) than were those performed lateral to a ratio of 0.30 (3/23, 13.0%) ( P < .01). There were no failures when the conoid ratio was <0.25 (0/10, 0%). Conoid tunnel placement was also statistically significant for predicting return to duty in our active-duty population. Conclusion: Medial tunnel placement is a significant factor in risk for early failures when performing anatomic CC ligament reconstructions. Preoperative templating is recommended to evaluate optimal placement of the clavicular bone tunnels. Placement of the conoid tunnel at 25% of the clavicular length from the lateral border of the clavicle is associated with a lower rate of lost reduction and a higher rate of return to military duty.
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Tanksley, John A., Brian C. Werner, Evan J. Conte, David P. Lustenberger, M. Tyrrell Burrus, Stephen F. Brockmeier, F. Winston Gwathmey, and Mark D. Miller. "ACL Roof Impingement Revisited: Does the Independent Femoral Drilling Technique Avoid Roof Impingement With Anteriorly Placed Tibial Tunnels?" Orthopaedic Journal of Sports Medicine 5, no. 5 (May 1, 2017): 232596711770415. http://dx.doi.org/10.1177/2325967117704152.

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Background: Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement. Purpose: To compare the potential for intercondylar roof impingement of ACL grafts with anteriorly positioned tibial tunnels after either transtibial (TT) or independent femoral (IF) tunnel drilling. Study Design: Controlled laboratory study. Methods: Twelve fresh-frozen cadaver knees were randomized to either a TT or IF drilling technique. Tibial guide pins were drilled in the anterior third of the native ACL tibial attachment site after debridement. All efforts were made to drill the femoral tunnel anatomically in the center of the attachment site, and the surrogate ACL graft was visualized using 3-dimensional computed tomography. Reformatting was used to evaluate for roof impingement. Tunnel dimensions, knee flexion angles, and intra-articular sagittal graft angles were also measured. The Impingement Review Index (IRI) was used to evaluate for graft impingement. Results: Two grafts (2/6, 33.3%) in the TT group impinged upon the intercondylar roof and demonstrated angular deformity (IRI type 1). No grafts in the IF group impinged, although 2 of 6 (66.7%) IF grafts touched the roof without deformation (IRI type 2). The presence or absence of impingement was not statistically significant. The mean sagittal tibial tunnel guide pin position prior to drilling was 27.6% of the sagittal diameter of the tibia (range, 22%-33.9%). However, computed tomography performed postdrilling detected substantial posterior enlargement in 2 TT specimens. A significant difference in the sagittal graft angle was noted between the 2 groups. TT grafts were more vertical, leading to angular convergence with the roof, whereas IF grafts were more horizontal and universally diverged from the roof. Conclusion: The IF technique had no specimens with roof impingement despite an anterior tibial tunnel position, likely due to a more horizontal graft trajectory and anatomic placement of the ACL femoral tunnel. Roof impingement remains a concern after TT ACL reconstruction in the setting of anterior tibial tunnel placement, although statistical significance was not found. Future clinical studies are planned to develop better recommendations for ACL tibial tunnel placement. Clinical Relevance: Graft impingement due to excessively anterior tibial tunnel placement using a TT drilling technique has been previously demonstrated; however, this may not be a concern when using an IF tunnel drilling technique. There may also be biomechanical advantages to a more anterior tibial tunnel in IF tunnel ACL reconstruction.
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Lall, Ajay C., David P. Beason, Jeffrey R. Dugas, and E. Lyle Cain. "The Effect of Humeral and Ulnar Tunnel Placement on Achieving UCL Graft Isometry." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (July 1, 2018): 2325967118S0016. http://dx.doi.org/10.1177/2325967118s00165.

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Objectives: The elbow medial ulnar collateral ligament (UCL) is frequently injured in throwing athletes, most commonly baseball pitchers. When conservative management fails, surgical intervention can allow the athlete to return to sport. While extensive research has been devoted to UCL graft incorporation and outcomes based on varying surgical techniques, there is a paucity of literature available addressing optimal bone tunnel placement in achieving medial UCL graft isometry. The purpose of this study is to assess the effect of humeral and ulnar bone tunnel placement on achieving UCL graft isometry through elbow range-of-motion. Methods: Ten fresh-frozen cadaveric upper extremities were dissected to expose the native UCL in its entirety. Three equidistant humeral and ulnar tunnels were created at each UCL footprint. Suture was passed between nine possible tunnel combinations for each elbow affixed to an isometry guage. Each elbow was moved through a 120-degree arc of motion for each tunnel combination at 0, 30, 60, 90, and 120 degrees. Measured changes in isometry gauge tension were recorded and analyzed using one-way analysis of variance (ANOVA) with Tukey’s HSD for pairwise comparisons. A p-value of 0.05 was used to determine significance for all tests. Results: There was an overall significant effect (p < 0.0001) of tunnel placement at all degrees of flexion measured. Pairwise comparisons revealed increases in displacement between the central and posterior tunnel positions of the medial epicondyle, with significant differences (p=0.0009) occurring when paired with both the central and posterior aspect of the sublime tubercle. Profound differences (p < 0.0001) were noted between the anterior and posterior humeral tunnel positions. No significant differences noted between ulnar tunnel locations at any humeral location. Figure 1: Tunnel placement in the central part of the medial epicondyle (Centralepi) was generally the most isometric grouping, with Centralepi - Anteriortub being the most isometric combination of all. Data are represented as mean +/- SEM. Conclusion: Isometric graft placement of the medial elbow UCL is undoubtedly dependent upon optimal tunnel placement and even slight deviations from the native centroid at either the medial epicondyle or sublime tubercle can possibly lead to early graft failure or abnormal joint kinematics. This information can aid surgeons in performing isometric single bone tunnel UCL reconstruction or repair procedures in the future.
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Dissertations / Theses on the topic "Tunnel placement"

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(9804632), Erik Hohmann. "The relationships between functional tests, muscular strength, outcome scores and radiological assessment in the ACL-deficient and ACL-reconstructed knee." Thesis, 2009. https://figshare.com/articles/thesis/The_relationships_between_functional_tests_muscular_strength_outcome_scores_and_radiological_assessment_in_the_ACL-deficient_and_ACL-reconstructed_knee/13463465.

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"Injuries to the anterior cruciate ligament (ACL) are amongst the most common knee injuries. To assess knee function in the ACL-deficient and ACL-reconstructed knee, a number of functional tests, strength measurements and questionnaires have been developed...Subjects were recruited from the Department of Orthopaedics Sports Injury Clinic at Rockhampton Hospital"--Abstract.
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Chen, Shih-Fang, and 陳世芳. "Analysis of the Effects of PCB Routing and Component Placement on the EMI Performance of RF Tuner System." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/96313004091208537068.

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碩士
國立交通大學
電機學院電信學程
100
This thesis mainly discusses how to use the routing skills and component placement of the printed circuit board to improve the EMI performance of RF tuner system. In general, in the beginning of the RF tuner IC development, we need to assess the system’s spectrum planning and linking budget and then select the appropriate tuner architecture. In the design process, power supply planning and integrated circuit layout, and in the final stage of design, the IC package types, pin definitions and bonding wires are all closely related to electromagnetic interference. In this thesis, based on the system design point of view, commercially available silicon terrestrial digital TV broadcast tuner (DVB-T silicon tuner) was selected as a research topic, we analyze the effects of single, and multi-point grounding, ground isolation, power supply filtering, and the IF signal oscillation caused by crosstalk etc. and explain how to use routing skills and suppression components to improve the electromagnetic interference performance of the RF tuner.
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Books on the topic "Tunnel placement"

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Syed, Almas, Robert Evans Heithaus, and Chet R. Rees. Elimination of Post-Procedural Bleeding After Placement of Tunneled Dialysis Catheters. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0047.

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This chapter discusses how to prevent postoperative bleeding with the placement of tunneled dialysis catheters. Tunneled intravenous chest catheters, particularly dialysis catheters, sometimes result in oozing or frank bleeding from the incisions during the first 24 hours after placement. This problem is exacerbated by the large diameter and stiffness of these catheters. Moreover, patients requiring these catheters frequently suffer from abnormal hemostasis profiles—an elevated international normalized ratio, thrombocytopenia, or abnormal platelet function due to uremia is commonly seen. The technique discussed in this chapter ensures that the potential bleeding sites throughout the operative site and tract are coated and permeated by a hemostatic agent.
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Rush, Michael, Cynthia Toot Ferguson, and S. Lowell Kahn. Placing a Jugular Port Without Direct Percutaneous Jugular Vein Access. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0043.

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A traditional subcutaneous port requires creation of a subcutaneous reservoir for the port and a separate small incision at the point of venous access, most commonly the internal jugular vein. The catheter of the port is tunneled from the port reservoir to the venous access incision and placed centrally through a peel-away sheath. Placing a subcutaneous jugular port without direct percutaneous jugular vein access is a skill that can be employed by the interventional radiologist and is described in this chapter. Considerations for site selection, accessing venous circulation, and appropriate placement of the port reservoir are described. This method of implanting a subcutaneous chest port has a high rate of technical success and low rate of complications.
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Book chapters on the topic "Tunnel placement"

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Okazaki, Ken. "Femoral Bone Tunnel Placement." In ACL Injury and Its Treatment, 183–99. Tokyo: Springer Japan, 2016. http://dx.doi.org/10.1007/978-4-431-55858-3_16.

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Siebold, Rainer, and Hans H. Pässler. "Fluoroscopy for Bone Tunnel Placement." In Anterior Cruciate Ligament Reconstruction, 181–84. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-45349-6_20.

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Hulet, Christophe, Goulven Rochcongar, and Valentin Chapus. "Tibial Bone Tunnel Placement (Arthroscopically and with Fluoroscopy)." In Anterior Cruciate Ligament Reconstruction, 147–58. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-45349-6_18.

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Spalding, Tim, Curtis Robb, and Charles H. Brown. "Femoral Bone Tunnel Placement (Arthroscopically and with Fluoroscopy)." In Anterior Cruciate Ligament Reconstruction, 159–79. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-45349-6_19.

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Lin, Yipeng, Qi Li, and Jian Li. "Lower Tibial Tunnel Placement in Transtibial PCL Reconstruction." In Minimally Invasive Functional Reconstruction of the Knee, 299–303. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3971-6_34.

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Shino, Konsei, Ryohei Uchida, Hiroyuki Yokoi, Tomoki Ohori, and Tatsuo Mae. "Technique Corner: ACLR Optimal Tunnel Placement: How to Get There?" In Advances in Knee Ligament and Knee Preservation Surgery, 35–41. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-84748-7_4.

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Michels, Frederick, Kentaro Matsui, and Filip Stockmans. "Anatomical Reflections When Considering Tunnel Placement for Ankle Ligament Reconstruction." In Lateral Ankle Instability, 245–51. Berlin, Heidelberg: Springer Berlin Heidelberg, 2021. http://dx.doi.org/10.1007/978-3-662-62763-1_28.

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Laboureau, J. P., and F. Marnat-Perrichet. "Isometric Reconstruction of the Anterior Cruciate Ligament: Femoral and Tibial Tunnel Placement." In Ligaments and Ligamentoplasties, 209–25. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-642-60428-7_10.

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Ohsawa, Takashi, Kenji Takagishi, and Masashi Kimura. "Tibial Bone Tunnel Placement in Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons." In ACL Injury and Its Treatment, 201–9. Tokyo: Springer Japan, 2016. http://dx.doi.org/10.1007/978-4-431-55858-3_17.

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Yevzlin, Alexander S. "Tunneled Femoral Hemodialysis Catheter Placement." In Dialysis Access Cases, 155–57. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57500-1_31.

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Conference papers on the topic "Tunnel placement"

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Wu, Peng, Yong Cui, Jianping Wu, and Minming Li. "Tunnel concentrator placement for traffic optimization in IPv4-IPv6 coexisting networks." In 2013 ICC - 2013 IEEE International Conference on Communication Workshop (ICC). IEEE, 2013. http://dx.doi.org/10.1109/iccw.2013.6649439.

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Harik, Ramy, Joshua Halbritter, Dawn Jegley, Ray Grenoble, and Brian Mason. "Automated Fiber Placement of Composite Wind Tunnel Blades: Process Planning and Manufacturing." In SAMPE 2019 - Charlotte, NC. SAMPE, 2019. http://dx.doi.org/10.33599/nasampe/s.19.1538.

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Haifeng Jiang, Jiansheng Qian, and Wei Peng. "Energy efficient sensor placement for tunnel wireless sensor network in underground mine." In 2009 2nd International Conference on Power Electronics and Intelligent Transportation System (PEITS). IEEE, 2009. http://dx.doi.org/10.1109/peits.2009.5406915.

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Grenoble, Ray, Ramy Harik, Daniel Munden, Joshua Halbritter, Dawn Jegley, and Brian Mason. "Assessment of Automated Fiber Placement for the Fabrication of Composite Wind Tunnel Blades." In SAMPE 2019 - Charlotte, NC. SAMPE, 2019. http://dx.doi.org/10.33599/nasampe/s.19.1574.

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Li, Yu, and Shuang Wang. "Effect of Smoke Exhaust Openings Placement Direction of Tunnel Ceiling Mechanical Exhaust System." In 2016 International Conference on Engineering Science and Management. Paris, France: Atlantis Press, 2016. http://dx.doi.org/10.2991/esm-16.2016.61.

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Halbritter, Joshua, Ramy Harik, Dawn Jegley, and Ray Grenoble. "Rapid Prototyping of Wind Tunnel Blade Geometry for Composite Manufacturing using Automated Fiber Placement." In CAD'19. CAD Solutions LLC, 2019. http://dx.doi.org/10.14733/cadconfp.2019.298-302.

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MASON, BRIAN, DANIEL MUNDEN, DAWN JEGLEY, RAY GRENOBLE, and RAMY HARIK. "Design and Analysis of a Tool for Automated Fiber Placement of Composite Wind Tunnel Blades." In American Society for Composites 2019. Lancaster, PA: DEStech Publications, Inc., 2019. http://dx.doi.org/10.12783/asc34/31303.

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Roy, Ting C., Daniel Markel, Casey Harrison, James Shelton, Leonard Harp, David Groesbeck, Gustavo Grullon, et al. "Powerful Material Technology Removes Barriers." In Offshore Technology Conference. OTC, 2021. http://dx.doi.org/10.4043/31311-ms.

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Abstract Strengthening materials through grain refinement often results in reduced ductility necessitating means to augment their elongation to failure for engineering applications. Grain boundary engineering (GBE), encompassing novel thermo-mechanical processing has shown promise of simultaneously enhancing both strength and ductility of materials and fracture behavior, especially with low stacking fault energy materials. The ultrahigh strength and reasonable ductility originate from dislocations being effectively blocked at the nano-twinned boundaries resulting in dislocation accumulation and entanglement. This necessitates the careful design of alloys and nano-composites, an effective harnessing of these unique sub-micron features to the benefit of engineering downhole tools for strategic applications. Enabled by these novel material developments, here we present two such articles for the unconventionals. First, a frangible barrier to abet placement of casings and liners through trapping an air column below the barrier while supporting a fluid column in the casing above, providing an up-thrust, a buoyant force that significantly reduces drag and lateral casing weight during placement. This is a viable concept because "shales don't kick". Second is the unmet need for a clean perforating tunnel allowing reduced fluid friction thus better reservoir connectivity. This has been achieved through the development of a novel shape charge with a reactive liner which during the detonation event, additionally generates reactive metallic glassy phase(s) and high entropy alloy complex(s) and their segregation in the deposited jet debris that lines the perf-tunnel. During flowback, reaction with aqueous fluids selectively etch these phases and stimulates the disintegration of the impervious skin on the perf-tunnel into fine particulates subsequently removing them, leaving behind a clear, clean tunnel.
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Tang, Elaine, Doff B. McElhinney, and Ajit P. Yoganathan. "Hemodynamic Impact of Stenting in the Total Cavopulmonary Connection With Lateral Tunnel Stenosis." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80252.

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2 per 1000 children in the US are born with functionally single ventricle (SV) heart defects. To restore the separate systemic and pulmonary circulations, a Total Cavopulmonary Connection (TCPC) is carried out through a series of surgical steps, which result in the direct connection of the superior vena cava (SVC) and inferior vena cava (IVC) to the pulmonary arteries without an intervening pulmonary ventricle. One way to complete the TCPC is by placing a synthetic patch in the right atrium, forming an intracardiac lateral tunnel (LT) as the final step. As patients grow, some LT pathways become stenosed. The stenosis can impose extra resistance to flow in addition to the TCPC in the SV circulation. One method of treating LT stenosis is by placement of an intravascular stent.
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Zhang, Guangyu, Xinran Wang, Xiaolin Li, Yuerui Lu, Ali Javey, and Hongjie Dai. "Carbon Nanotubes: From Growth, Placement and Assembly Control to 60mV/decade and Sub-60 mV/decade Tunnel Transistors." In 2006 International Electron Devices Meeting. IEEE, 2006. http://dx.doi.org/10.1109/iedm.2006.346804.

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Reports on the topic "Tunnel placement"

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Chang, Ke-Vin. Ultrasonography for the Diagnosis of Carpal Tunnel Syndrome: A Protocol for an Umbrella Review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0058.

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Review question / Objective: This meta-analysis aimed to compare the clinical effectiveness and safety between radioactive versus normal stent insertion for patients with malignant hilar obstruction. Condition being studied: Malignant hilar obstruction (MHO) is a common clinical condition that is caused by the hilar cholangiocarcinoma, gallbladder carcinoma, or hilar metastasis. Most of the patients with MHO underwent palliative biliary drainage or stening by an endoscopic or percutaneous approach until end of life. The previous studies suggested that that bilateral stent placement and the use of metal stents are superior to unilateral and plastic stents in the items of stent patency. However, bilateral stenting did not improve the patients’ overall survival (OS) because stent alone had no treatment effect on the tumors themselves. Although several treatment options, including chemotherapy, external radiation, intra-ductal brachytherapy, etc, has been used to prolong the stent patency and OS for patients with malignant biliary obstruction (MBO), intra-ductal brachytherapy using I-125 seeds has been widely used because of its persistent brachytherapeutic effect. To combine the I-125 seeds and metal stent together, many researchers have developed a radioactive stent (RS) for the patients with MBO. Many meta-analyses also confirmed that RS insertion was associated with significant longer stent patency and OS for patients with MBO when compared to normal stent (NS). However, whether RS can also provide a good effectiveness for patients with MHO is still unclear.
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