Comparison of two methods of femoral tunnel preparation in single-bundle anterior cruciate ligament reconstruction: a prospective randomized study

Abstract

PURPOSE: To prospectively compare therapeutic effect of femoral tunnel preparation through the tibial tunnel and the anteromedial (AM) portal in single-bundle anterior cruciate ligament (ACL) reconstruction. METHODS: Between June 2008 and October 2010, 76 patients underwent single-bundle ACL reconstruction by autogenous grafting of semitendinosus and gracilis tendon. All cases were randomly divided into two groups according to the method of femoral tunnel preparation: transtibial (TT) group (n=38) and anteromedial (AM) group (n=38). Lysholm knee score and the KT-1000 anterior laxity at 30° of pre-and post-operation were assessed for two groups. RESULTS: Sixty-five patients (TT group, 34; AM group, 31) were followed up for more than 12 months, with a follow-up rate of 86%. The Lysholm knee score and the KT-1000 anterior laxity 12 months after operation were significantly better than before reconstruction. The Lysholm knee score and the KT-1000 anterior laxity were not significantly different between the TT and AM groups after operation. CONCLUSION: Femoral tunnel preparation through tibial tunnel or the anteromedial portal in single-bundle anterior cruciate ligament reconstruction shows same therapeutic effects.

Transtibial Versus Independent Drilling Techniques for Anterior Cruciate Ligament Reconstruction

“…Four of the studies compared OI and TT drilling, 12,30,50,53 while 2 compared AMP and TT drilling. 34,80 An assessment of study quality was performed, and the results are summarized in Figure 3.…”

A meta‑analysis on anterior cruciate ligament reconstruction: Is modified transtibial technique inferior to independent drilling techniques?

“…The difference in the anterior displacement of the tibia between bilateral knee joints was employed to assess the difference in anterior displacement of the tibia between the operated and the intact knees (14,19–21,24,25). In four studies, the KT-1000 knee arthrometer was adopted while the KT-2000 knee arthrometer was applied to another two studies.…”

Conventional trans-tibial versus anatomic medial portal technique for femoral tunnel preparation in anterior cruciate ligament reconstruction; comparison of clinical outcomes

“…[12] Although various data regarding the effectiveness of AMP technique is available, significant scarcity is present about the studies comparing the AMP technique with conventional TT technique. [13,14] In a meta-analysis, comparing the outcomes of the AMP technique (eight studies, 257 patients) with those of the TT technique (13 studies, 602 patients), the patients undergoing the AMP technique had more satisfactory clinical outcomes at 1-2 year follow-up. [15] Another meta-analysis of 15 studies showed that IKDC scores or Tegner scores were similar between TT technique and free-hand drilling techniques and regression analysis of 22 studies also showed that failure rates and objective IKDC scores were also similar between two techniques.…”