Novice Surgeon Portal Preference to Visualize the Femoral Anterior Cruciate Ligament Footprint: The Accessory Medial Portal Offers Improved Visualization

Abstract

Purpose To evaluate participant opinions on the appropriateness of different viewing angles by asking 8 questions, using visual content techniques. Methods Survey information from participants was used in this study. We used images of a patient who was operated on for symptomatic knee instability. Participants were asked whether the visual angle could determine the femoral tunnel entry point or evaluate anterior cruciate ligament (ACL) integrity. Results Questionnaires were completed by 40 participants. When all responses were evaluated, participant opinions on the accessory medial portal (AMP) were more positive than opinions on images taken from the anterolateral portal (ALP). These observations were statistically significant ( P < .005). Both ACL integrity assessments and femoral tunnel entry site questions were evaluated, we observed that participant opinions on the AMP for both types of evaluation were more positive than opinions on the ALP. This observation was statistically significant ( P < .005). When evaluations with photos and video transcripts were compared, no significant differences in terms of participant opinions were observed ( P < .005). Conclusions AMP use may be a valuable tool for assistant and postgraduate education, as it offers a more suitable view angle for ACL reconstruction. Level of evidence Level V, survey study.

Trends in Primary Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction Practice in Adult Patients Prevalent Among Arthroscopy Surgeons of Six Southern States of India

“…Regarding the portal usage to visualize femoral footprint and establish femoral tunnel Our survey has a broad consensus that surgeons prefer the AL portal over AM portal to visualize femoral footprint (Tables 4, 5). Although the AL portal remains a preferred portal to visualize and establish the femoral tunnel, several authors suggest visualization via AM portal as that provides an orthogonal view of the femoral footprint rather than an oblique or tangential view from the AL portal, and that may help in more precise identification of the footprint [20,21]. However, a recently concluded study found no difference between the two techniques [22].…”