Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction

Abstract

III.

Comparisons of tunnel-graft angle and tunnel length and position between transtibial and transportal techniques in anterior cruciate ligament 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).…”

“…Nishimoto et al [21] reported that the mean anteromedial (AM) femoral-graft bending angle was more acute than the mean posterolateral (PL) femoral-graft bending angle in double-bundle ACL with the transportal technique. Wang et al [13] reported that AM and PL femoral-graft angles in double-bundle ACL reconstruction using the transportal technique were more acute than single-bundle ACL reconstruction using the transtibial technique. As far as we are aware, this is the only study comparing graft bending angles at flexion and extension in single-bundle ACL reconstruction between transtibial and transportal techniques.…”

“…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 graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

“…Outsidein (OI) and trans-tibial (TT) models created at 90° were matched to 0° and 130° models. Trans-portal (TP) models created at 130° were matched to 0° and 90° models consistent with our results [57]. There was a tendency that TT technique would reduce the bending angle for AM and singlebundle grafts, although it was still as high as 70° and GBA of PL-bundle in TT technique was even higher in our series.…”

Relationship between femoral tunnel location and graft bending angle in outside-in and transportal technique for ACL double bundle reconstruction in 3D-CT study

“…Some previous studies have analyzed the femoral graft bending angle between femoral tunnel axis and graft at the femoral tunnel aperture in ACL reconstruction [12,16,18,23,26,27]. However, the relationship between femoral tunnel location and femoral graft bending angle has been little investigated.…”