Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 10, 481-489
eCollection

Comparing Transtibial and Anteromedial Drilling Techniques for Single-bundle Anterior Cruciate Ligament Reconstruction

Affiliations

Comparing Transtibial and Anteromedial Drilling Techniques for Single-bundle Anterior Cruciate Ligament Reconstruction

Erhan Sukur et al. Open Orthop J.

Abstract

Background: Among the many factors that determine the outcome following anterior cruciate ligament (ACL) reconstruction, the position of the femoral tunnel is known to be critically important and is still the subject of extensive research.

Objective: We aimed to retrospectively compare the outcomes of arthroscopic ACL reconstruction using transtibial (TT) or anteromedial (AMP) drilling techniques for femoral tunnel placement.

Methods: ACL reconstruction was performed using the TT technique in 49 patients and the AMP technique in 56 patients. Lachman and pivot-shift tests, the Lysholm Knee Scale, International Knee Documentation Committee (IKDC) score, Tegner activity scale and visual analog scale (VAS) were used for the clinical and functional evaluation of patients. Time to return to normal life and time to jogging were assessed in addition to the radiological evaluation of femoral tunnel placement.

Results: In terms of the Lysholm, IKDC, Tegner score, and stability tests, no significant differences were found between the two groups (p > 0.05). Statistical analysis revealed reduced time to return to normal life and jogging in the AMP group (p < 0.05). The VAS score was also significantly reduced in the AMP group (p < 0.05). The position of the femoral tunnel was anatomically appropriate in 51 patients in the AMP group and 5 patients in the TT group.

Conclusion: The AMP technique is superior to the TT technique in creating anatomical femoral tunnel placement during single-bundle ACL reconstruction and provides faster recovery in terms of return to normal life and jogging at short-term follow-up.

Keywords: Anterior cruciate ligament; Anteromedial portal; Drilling; Femoral tunnel; Graft; Transtibial technique.

Figures

Fig. (1)
Fig. (1)
Frontal magnetic resonance imaging (MRI) demonstrating the horizontal orientation of the graft in the femoral tunnel.
Fig. (2)
Fig. (2)
The femoral tunnel angle (A) and inclination angle (B) suggest that the reconstructed ACL is within the anatomical range.

Similar articles

See all similar articles

Cited by 4 PubMed Central articles

References

    1. Alentorn-Geli E., Samitier G., Alvarez P., Steinbacher G., Cugat R. Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up. Int. Orthop. 2010;34(5):747–754. doi: 10.1007/s00264-010-1000-1. - DOI - PMC - PubMed
    1. Saccomanni B. Graft fixation alternatives in anterior cruciate ligament reconstruction. Musculoskelet. Surg. 2011;95(3):183–191. doi: 10.1007/s12306-011-0137-4. - DOI - PubMed
    1. Rayan F., Nanjayan S.K., Quah C., Ramoutar D., Konan S., Haddad F.S. Review of evolution of tunnel position in anterior cruciate ligament reconstruction. World J. Orthop. 2015;6(2):252–262. doi: 10.5312/wjo.v6.i2.252. - DOI - PMC - PubMed
    1. Fu F.H., van Eck C.F., Tashman S., Irrgang J.J., Moreland M.S. Anatomic anterior cruciate ligament reconstruction: a changing paradigm. Knee Surg. Sports Traumatol. Arthrosc. 2015;23(3):640–648. doi: 10.1007/s00167-014-3209-9. - DOI - PubMed
    1. Jepsen C.F., Lundberg-Jensen A.K., Faunoe P. Does the position of the femoral tunnel affect the laxity or clinical outcome of the anterior cruciate ligament-reconstructed knee? A clinical, prospective, randomized, double-blind study. Arthroscopy. 2007;23(12):1326–1333. doi: 10.1016/j.arthro.2007.09.010. - DOI - PubMed

LinkOut - more resources

Feedback