A Comparison of 2 Drilling Techniques on the Femoral Tunnel for Anterior Cruciate Ligament Reconstruction

Comparisons of tunnel-graft angle and tunnel length and position between transtibial and transportal techniques in anterior cruciate ligament reconstruction

“…Miller et al [16] and Chang et al [15] reported that femoral tunnel length following the transportal technique was shorter than that using the transtibial technique, which is consistent with the results of our study (40.7 mm and 34.7 mm in transtibial and transportal groups, respectively). It is well known that tunnel length changes according to knee flexion angle in the transportal technique in ACL reconstruction.…”

“…Several studies report that the transportal technique for ACL reconstruction has a risk of short femoral tunnel length [13][14][15][16]. Miller et al [16] and Chang et al [15] reported that femoral tunnel length following the transportal technique was shorter than that using the transtibial technique, which is consistent with the results of our study (40.7 mm and 34.7 mm in transtibial and transportal groups, respectively).…”

“…However, the transportal technique has some possible disadvantages [14][15][16]. In this study, we compared 3D bending angle between graft and tunnel, and tunnel length and position between the two techniques using 3D knee models.…”

“…To address problems related to a vertical femoral tunnel, some surgeons have advocated performing independent drilling (transportal technique) through an anteromedial portal to place the femoral tunnel in the anatomical position instead of using the standard transtibial drilling technique [4,[10][11][12]. While some studies have reported that anteromedial portal drilling could place the femoral tunnel in the anatomical position better than transtibial drilling [10,12,13], other studies reported possible disadvantages, such as short tunnel length, posterior-wall blowout, neurovascular damage of the lateral side of the knee and partial graft rupture due to excessive stress [13][14][15][16].…”

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

“…Femoral tunnels can be prepared with transtibial (TT), anteromedial (AM) and outside-in techniques 1 . As for the clinical efficacy of femoral tunnels with different surgical procedures, morphological outcomes are given much attention to but functional recovery is rarely investigated [2][3][4][5] . In this study, single-bundle ACL reconstruction was conducted by grafting autogenous semitendinosus and gracilis tendon and effects of the two procedures on postoperative functional recovery were prospectively compared.…”