Femoral tunnel drilling in anterior cruciate ligament reconstruction: Anteromedial or transtibial portal? Current review

Sedeek, SM; Andrew, Thc

doi:10.13172/2050-2303-2-4-718

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…2,10,17 Nevertheless, anteromedial technique includes a risk of blow out of the lateral femoral condyle, articular damage, has a steep learning curve as compared to the trans-tibial technique, short femoral tunnel lengths making the graft passage little tedious. 7,18,19 In the present study, there was a statistically significant difference in both the groups in terms of femoral tunnel position. The femoral tunnel in patients with group A was more posterior to the Blumensaat's line in sagittal plane and more medial in coronal plane (10 O' clock position).…”

Section: Discussionsupporting

confidence: 46%

Anteromedial versus trans-tibial technique for anterior cruciate ligament reconstruction using quadrupled hamstring graft: a comparative study

Singh¹,

Sharma

Akshay³

2019

Int J Res Orthop

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Background: Femoral tunnel position plays a pivotal role for successful outcome in anterior cruciate ligament (ACL) reconstruction surgeries. Recently, the anteromedial techniques have gained popularity over the trans-tibial technique due to better anatomical position and better stability rotationally and antero-posteriorly then the later. The aim of the present study was to compare the technical difficulty and ease, functional and radiological outcome of trans-tibial and anteromedial portal techniques in ACL reconstruction.Methods: Thirty patients between March 2015 and February 2016 with ACL tear underwent arthroscopic reconstruction using quadrupled hamstring graft and were divided into two groups A (anteromedial) and group B (trans-tibial) as per the technique used. Patients with multiligament injuries, revision surgeries, and osteoarthritis knee were excluded. All the patients were followed-up for 24 months and clinical Lysholm and IKDC scores along with radiological outcome were calculated.Results: The mean age of patients were 32.4±6.3 years. Isolated ACL tear was seen in 16 (53.4%) cases followed by medial meniscus injury in 11 (36.6%) patients. The mean duration between injury and surgery was 14.8±8.99 and 21.6±3.23 days in group A and B respectively (p=0.0122). The radiological position of femoral tunnel in sagittal and coronal plane was statistically significant in both the groups. The Lysholm and IKDC scores showed statistically significant difference at 3 months post-operatively.Conclusions: Anteromedial and trans-tibial techniques have similar long term functional outcomes. However, more anatomical position of the graft through the anteromedial technique and better rotational and anteroposterior stability makes it theoretically to be superior to the trans-tibial technique.

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Section: Discussionsupporting

confidence: 46%

Anteromedial versus trans-tibial technique for anterior cruciate ligament reconstruction using quadrupled hamstring graft: a comparative study

Singh¹,

Sharma

Akshay³

2019

Int J Res Orthop

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“…Furthermore, these studies suggest that a more horizontal placement of the graft decreases the risk of graft impingement [ 10 , 29 , 30 ]. However, there are several potential surgical difficulties with regard to the AMP technique, including a short femoral tunnel, blow out of the back wall of the lateral femoral intercondylar notch, and difficulty with visualization and graft passage [ 31 ]. Nevertheless, in the present study, the AMP technique was found to be superior to the TT technique in creating femoral tunnels within anatomical range, according to the radiological evaluation method of Illingworth.…”

Section: Discussionmentioning

confidence: 99%

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

Sukur

Akman²,

Senel³

et al. 2016

TOORTHJ

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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.

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Femoral tunnel drilling in anterior cruciate ligament reconstruction: Anteromedial or transtibial portal? Current review

Cited by 2 publications

References 27 publications

Anteromedial versus trans-tibial technique for anterior cruciate ligament reconstruction using quadrupled hamstring graft: a comparative study

Anteromedial versus trans-tibial technique for anterior cruciate ligament reconstruction using quadrupled hamstring graft: a comparative study

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

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