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Randomized Controlled Trial
, 19 (1), 454

Comparison of 2 Femoral Tunnel Drilling Techniques in Anterior Cruciate Ligament Reconstruction. A Prospective Randomized Comparative Study

Randomized Controlled Trial

Comparison of 2 Femoral Tunnel Drilling Techniques in Anterior Cruciate Ligament Reconstruction. A Prospective Randomized Comparative Study

Yunhang Geng et al. BMC Musculoskelet Disord.


Background: To evaluate the length and position of femoral tunnel,and exam whether knee stability and clinical functional outcomes are superior in AMP method.

Methods: From August 2014 to February 2015, we prospectively recruited 104 patients undergoing anterior cruciate ligament reconstruction. They were randomized to anteromedial portal or transtibial method. All patients underwent Lysholm score, International Knee Documentation Committee score,Tegner score at pre-operative and last follow-up point as subjective assessment of clinical function. The Lachman test, the Pivot-shift test and KT-1000 were performed at the last follow-up as a evaluation of knee joint stability. We measured the length of femoral tunnel intraoperatively and at 1 week post-operatively, CT-based three-dimensional reconstruction was used to assess femoral tunnel location.

Results: The average follow-up time of anteromedial portal group was 25.7 ± 6.8 months (range:12-36.5 months), and the average follow-up time of the transtibial group was 24.9 ± 6.0 months (range:12-37 months). There was no significant difference between the groups pre-operative Lysholm score, IKDC score and Tegner scores. Both groups showed significantly improvement in these clinical function scores at follow up for their ACL reconstruction. However, there was no significant difference in the function scores between the two groups at last follow up. However, the mean femoral tunnel length in the anteromedial portal group was significantly shorter than that in the transtibial group. And tunnel location was significantly lower and deeper with the anteromedial portal technique than with the transtibial technique.

Conclusion: The use of anteromedial portal method resulted in a significantly lower and deeper placement of the femoral tunnel, and a shorter tunnel length compared to the transtibial method. However, there was no statistical difference in terms of clinical function and knee joint stability between the anteromedial portal method and the transtibial method.

Trial registration: Name of the registry: Chinese Clinical Trial Registry. The registration number: ChiCTR1800014874 . The date of registration: 12 February, 2018. The study is retrospectively registered.

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

Conflict of interest statement

Ethics approval and consent to participate

The research was reviewed and written approved by the Ethic Committee of the Qindao University Medical College Affiliated Yantai Yuhuangding Hospital. And written informed consent was obtained from all study participants.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Fig. 1
Fig. 1
A depth gauge was used to hook the outer cortex of the femoral tunnel and intraoperative measurement of femoral tunnel depth is seen(*)
Fig. 2
Fig. 2
Blumensaat’s line is represented by ‘d’,with ‘b’ representing the line perpendicular to it. ‘a’ is the distance between the femoral tunnel center to Blumensaat’s line, and ‘c’ is the distance between the femoral tunnel center to b. Thus, a/b represents the height ratio, i.e., the ratio of the distance between the femoral tunnel center and the top of intercondylar notch to the total height of intercondylar notch; and c/d represents the depth ratio, i.e., the ratio of the distance between the femoral tunnel center and posterior articular surface of femoral lateral condyle to the total depth of intercondylar notch

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