A Prospective study on the functional outcome following arthroscopic ACL reconstruction with the femoral interference screw placed through the PT (Patellar Tendon) portal and the AM (Antero-Medial) portal

Abstract

The knee joint is the most commonly injured of all joints and the anterior cruciate ligament is the most commonly injured ligament. Arthroscopic reconstruction of torn ACL has become the gold standard in treating ACL tears. The primary aim of this prospective randomized comparative study was to investigate whether an interference screw placed through the PT portal shows less divergence as compared with a screw placed through the AM portal. Materials and Methods: This is a randomized controlled study. 24 patients have been included in the study. Femoral tunnel-interference screw divergence will be measured on postoperative digital lateral Xrays. Ha's method will be used to grade divergence. The radiologist was blinded for the technique used (AM or PT portal).The clinical outcome will be assessed by postoperative intervention knee documentation committee grading (IKDC) and Lysholm score at two year follow up. The study shall be of two and half years duration with effect from May 2015 to October 2017. Results: In our series of 24 patients, mean age was 30.6 years.With respect to the IKDC scoring, 95.83 % patients had normal or nearly normal outcome and 4.16% had abnormal outcomes. We had 95.83 % excellent and good results with respect to Lysholm score, 4.16 % had fair outcome and we did not have any poor outcomes. In our study we had 12 patients in each group (AM and PT). The mean divergence in group 1 (AM portal) is 13.15 o . Mean angle of divergence in group 2 (PT portal) is 7.24 o Conclusion: Arthroscopic ACL reconstruction using bone-patellar tendon-bone autograft provides a stable knee with minimal complications. The short term results of femoral interference screw placement through the patellar tendon portal for arthroscopic ACL reconstruction using bone patellar tendon bone graft are encouraging with minimal screw divergence with a good clinical outcome.