Accuracy of the newly developed Zimmer Biomet Root Aiming guide in tibial tunnel creation compared with that of conventional guides

Takaaki Hiranaka; Takayuki Furumatsu; Yuki Okazaki; Keisuke Kintaka; Naohiro Higashihara; Masanori Tamura; Eiji Nakata; Toshifumi Ozaki

doi:10.1016/j.asmart.2023.03.001

Accuracy of the newly developed Zimmer Biomet Root Aiming guide in tibial tunnel creation compared with that of conventional guides

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Apr 6:32:1-6. doi: 10.1016/j.asmart.2023.03.001. eCollection 2023 Apr.

Authors

Takaaki Hiranaka^{1

2}, Takayuki Furumatsu¹, Yuki Okazaki¹, Keisuke Kintaka¹, Naohiro Higashihara¹, Masanori Tamura¹, Eiji Nakata¹, Toshifumi Ozaki¹

Affiliations

¹ Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
² Department of Orthopaedic Surgery, Ako Central Hospital, 52‑6 Sohmon‑cho, Ako, Hyogo 678‑0241, Japan.

Abstract

Background/objective: Accurate tibial tunnel creation is crucial for successful transtibial pullout repair of medial meniscus (MM) posterior root tears (MMPRTs). This study aimed to evaluate the accuracy of the newly developed Zimmer Biomet Root Aiming (ZeBRA) guide for transtibial pullout repair of MMPRTs.

Methods: This study included 50 patients who underwent transtibial pullout repair using the Unicorn Meniscal Root (UMR) (n = 25) and ZeBRA (n = 25) guides. The expected anatomic centre (AC) and tibial tunnel centre (TC) were assessed using three-dimensional postoperative computed tomography (CT) images. The expected AC was defined as the centre of the circle tangent to the triangular footprint of the MM posterior root. The expected AC and TC on the tibial surface were assessed using the percentage-based posterolateral location on the tibial surface. The absolute distance between the AC and TC (mm) was evaluated.

Results: The mean AC location was 76.1% ± 3.1% posterior and 40.8% ± 2.1% lateral, whereas the mean TC location was 76.7% ± 5.3% posterior and 37.2% ± 3.6% lateral using the UMR guide and 75.8% ± 3.1% posterior and 36.5% ± 2.4% lateral using the ZeBRA guide. No significant difference was observed in the absolute distance between the UMR and ZeBRA guides (3.9 ± 1.4 and 3.8 ± 1.3 mm, respectively; p = 0.617).

Conclusions: The newly developed ZeBRA guide allows accurate tibial tunnel creation, and its accuracy is comparable to that of the conventional UMR guide. Tibial tunnels were created at optimal positions using both guides, and the choice of the guide would depend on the surgeon's preference.

Keywords: Meniscus; Musculoskeletal diseases; Orthopaedic procedures; Tibial tunnel; Zimmer biomet root aiming guide.