Outcome of arthroscopic single-bundle anterior cruciate ligament reconstruction: anteromedial portal technique versus transtibial drilling technique

Rezazadeh, Soorena; Ettehadi, Hossein; Vosoughi, Amir Reza

doi:10.1007/s12306-015-0392-x

Cited by 15 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Antero-medial technique has gained more popularity recently due to a more vertical tibial tunnel, less graft tunnel mismatch, greater graft obliquity, centrally placed femoral graft, better pivot shift and rotational stability. 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.…”

Section: Discussionmentioning

confidence: 99%

“…Anterior cruciate ligament (ACL) is one of the main structures of the knee and is responsible for anteroposterior and rotational stabilization in transverse and frontal plane. 1,2 Anterior knee instability associated with rupture of the anterior cruciate ligament is a disabling clinical problem, especially in an athletic individual, it predisposes the knee to subsequent injuries like secondary meniscal tear and chondral injuries. 3 Tunnel position at femur and tibial side and subsequent graft position are of one of the major determinants for a long term successful outcome in ACL injuries.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…8,9 However, controversy still remains as some outcome studies and systematic reviews have shown no clinical differences and no difference in failure rates in short-to mid-term follow-up between TT and AMP techniques. 10,11 In our technique (Video 1), a 7-mm over-the-back offset femoral guide is introduced through the AMP and placed over the posterior edge of the femur. The knee is flexed to 120 and the guide pin is assessed to ensure it exits anterolateral and not posteriorly through the femur.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft and a Medial Parapatellar Portal

Kim

McQueen

Watson

et al. 2016

Arthroscopy Techniques

View full text Add to dashboard Cite

Anterior cruciate ligament (ACL) reconstruction is one of the most extensively studied surgical procedures in orthopaedics. The importance of this ligament for knee function and stability has been widely studied. For athletes who participate in activities involving cutting, twisting, and running, surgical reconstruction of the ACL has become the standard of care. However, there is much debate regarding the techniques involved in ACL reconstruction, including graft choice, technique of drilling the femoral tunnel, and single- versus double-bundle reconstruction. In recent studies, ACL femoral tunnel drilling via a medial parapatellar or accessory anteromedial portal provides a more anatomic graft placement than transtibial femoral drilling. Long-term outcomes of these techniques have not been widely studied. This article details our technique for ACL reconstruction with bone-patellar tendon-bone autograft and a medial parapatellar portal.

show abstract

“…The low AMP was created under arthroscopic visualization; a spinal needle was advanced into the joint just above the anterior horn of the medial meniscus and 1.5 cm medial to the medial border of patellar tendon and to create the femoral tunnel independently from the tibial tunnel. It is important to keep a security distance at least 2 mm from the cartilage of the medial femoral condyle once the drill passes through this portal [ 16 ]. The midpoints of the remnants of the anteromedial and posterolateral bundles of the ACL were marked with a thermal device.…”

Section: Methodsmentioning

confidence: 99%

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

Sukur

Akman²,

Senel³

et al. 2016

TOORTHJ

View full text Add to dashboard Cite

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.

show abstract

Outcome of arthroscopic single-bundle anterior cruciate ligament reconstruction: anteromedial portal technique versus transtibial drilling technique

Abstract: There is no superiority of AMP technique on TT technique in ACL reconstructive surgeries. It could be suggested that performing a well-done technique, either TT or AMP, may be more important than only choosing a technique.

Cited by 15 publications

References 34 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

Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft and a Medial Parapatellar Portal

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

Contact Info

Product

Resources

About