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Review
, 12 (1), 167

Anteromedial Versus Transtibial Technique in Single-Bundle Autologous Hamstring ACL Reconstruction: A Meta-Analysis of Prospective Randomized Controlled Trials

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Review

Anteromedial Versus Transtibial Technique in Single-Bundle Autologous Hamstring ACL Reconstruction: A Meta-Analysis of Prospective Randomized Controlled Trials

Haitao Chen et al. J Orthop Surg Res.

Abstract

Background: The aim of this study was to compare the clinical outcome and postoperative complication between single-bundle anterior cruciate ligament (ACL) reconstruction with an anteromedial (AM) technique and a transtibial (TT) technique.

Methods: The study includes clinical randomized controlled trials comparing the clinical outcomes of ACL reconstruction using the autologous hamstring tendon with an AM method and a TT method published up to September 2017 were retrieved from PubMed, Cochrane Library, and Embase databases. Relevant data were extracted and the Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality. Stata/SE 12.0 was used to perform a meta-analysis of the clinical outcome.

Results: Five RCTs were included, with a total of 479 patients: 239 patients and 240 patients in the AM group and the TT group, respectively. Assessing postoperative stability, better results were found in the AM group for the negative rate of the Lachman test (P < 0.05), the negative rate of the pivot-shift test (P < 0.05) and the side-to-side difference (P < 0.05). Assessing postoperative functional outcome, the AM group yielded superior results in proportion with International Knee Documentation Committee (IKDC) grade A (P < 0.05) and the Lysholm scores (P < 0.05) but had a comparable IKDC score (P > 0.05). In terms of postoperative complication, no significant difference was found between the AM group and the TT group (P > 0.05).

Conclusions: The outcome of single-bundle ACL reconstruction with the AM technique is better than that with the TT technique in terms of postoperative stability and functional recovery of the knee.

Keywords: Anterior cruciate ligament; Anteromedial; Meta-analysis; Reconstruction; Transtibial.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flowchart of article selection process
Fig. 2
Fig. 2
Forest plot of negative Lachman test
Fig. 3
Fig. 3
Forest plot of negative pivot-shift test
Fig. 4
Fig. 4
Forest plot of IKDC grades. WMD, weighted mean difference
Fig. 5
Fig. 5
Forest plot of IKDC scores
Fig. 6
Fig. 6
Forest plot of Lysholm scores
Fig. 7
Fig. 7
Forest plot of SSD
Fig. 8
Fig. 8
Forest plot of postoperative complication
Fig. 9
Fig. 9
Funnel plot of publication bias for negative Lachman test

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