Is there any clinical superiority of the anteromedial portal compared to the Transtibial in Anterior Cruciate Ligament reconstruction in non-professional athlete patients in short term follow-ups?

Taşdemir, Zeki; Gülabi, Deniz; Ozal, Safiye Tokgoz; Sağlam, Fevzi; Elmalı, Nurzat

doi:10.3944/aott.2015.15.0016

Cited by 11 publications

(13 citation statements)

References 26 publications

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“…Several studies have shown that the AM elicited greater knee stability and improved the functional outcomes [ 17 , 18 , 23 , 24 ]. On the contrary, other researchers have claimed that no definitive evidence could conclude that the AM technique was superior to the TT technique [ 10 , 25 – 29 ] and the former might increase several other complications [ 17 , 30 – 33 ].…”

Section: Introductionmentioning

confidence: 99%

Anteromedial versus transtibial technique in single-bundle autologous hamstring ACL reconstruction: a meta-analysis of prospective randomized controlled trials

Chen

Tie

et al. 2017

J Orthop Surg Res

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BackgroundThe aim of this study was to compare the clinical outcome and postoperative complication between single-bundle anterior cruciate ligament (ACL) reconstruction with an anteromedial (AM) technique and a transtibial (TT) technique.MethodsThe study includes clinical randomized controlled trials comparing the clinical outcomes of ACL reconstruction using the autologous hamstring tendon with an AM method and a TT method published up to September 2017 were retrieved from PubMed, Cochrane Library, and Embase databases. Relevant data were extracted and the Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality. Stata/SE 12.0 was used to perform a meta-analysis of the clinical outcome.ResultsFive RCTs were included, with a total of 479 patients: 239 patients and 240 patients in the AM group and the TT group, respectively. Assessing postoperative stability, better results were found in the AM group for the negative rate of the Lachman test (P < 0.05), the negative rate of the pivot-shift test (P < 0.05) and the side-to-side difference (P < 0.05). Assessing postoperative functional outcome, the AM group yielded superior results in proportion with International Knee Documentation Committee (IKDC) grade A (P < 0.05) and the Lysholm scores (P < 0.05) but had a comparable IKDC score (P > 0.05). In terms of postoperative complication, no significant difference was found between the AM group and the TT group (P > 0.05).ConclusionsThe outcome of single-bundle ACL reconstruction with the AM technique is better than that with the TT technique in terms of postoperative stability and functional recovery of the knee.

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Section: Introductionmentioning

confidence: 99%

Anteromedial versus transtibial technique in single-bundle autologous hamstring ACL reconstruction: a meta-analysis of prospective randomized controlled trials

Chen

Tie

et al. 2017

J Orthop Surg Res

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“…The two important ligaments providing this stability are the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL), the anatomy of which are becoming increasingly known [1–4]. As a result of studies which have focused on the equivalence of the ACL and PCL projections, there has been extensive research on the anatomic dimensions of the ACL and PCL and variations have been determined in various individuals [5].…”

Section: Introductionmentioning

confidence: 99%

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Yılmaz

Özdemir

Keskinöz

et al. 2016

BioMed Research International

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Background. The aim of the study was to evaluate whether or not there was any incompatibility between four-strand hamstring tendons taken from the same knee and the dimensions of the ACL and PCL. Methods. 15 fresh frozen cadaver hamstrings were prepared as four-strand grafts and measurements made of the ACL and PCL circumferences in the midsection were made in the narrowest part of the midsection. The cross-section areas and diameters were calculated with geometric calculations used to measure the cross-sectional area of cylinders. Accepting that the geometric insertions were elliptical, the length, width, and area were calculated for entry areas. Results. A significant relationship at 96.2% was determined between the ACL mid and the hamstring diameter. A significant relationship at 96.7% was determined between the ACL and the hamstring mid area. A significant relationship at 96.4% was determined between the PCL mid and the hamstring diameter. A significant relationship at 95.7% was determined between the PCL and the hamstring mid area. Conclusion. For the reconstruction of ACL and PCL, it was determined that there is less incompatibility between the four-strand hamstring tendons taken from the same knee and the dimensions of the midsection PCL compared to the ACL dimensions.

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“…Ilahi et al 1 reported a mean femoral tunnel clock-face position of 10:18 (range, 10:00-10:30) in patients treated with the AAMP technique. Taşdemir et al 28 reported a mean femoral tunnel clock-face position of 10:10 (range, 9:50-10:25) in patients treated with the AMP technique. In this study, the mean femoral tunnel clock-face position was 10:13 (range, 09:42-10:33) in the AMP group and 10:24 (range, 9:49-10:46) in the AAMP group for the right knee; for the left knee, these values were 1:49 (range, 1:33-2:03) in the AMP group and 1:36 (range, 1:23-1:45) in the AAMP group.…”

Section: Discussionmentioning

confidence: 99%

“…The independent AMP technique is thought to achieve better positioning of the femoral tunnel and the native ACL footprint and allow more posterior positioning of the graft on the wall of the lateral femoral condyle than the traditional TT approach. 27,28 A recent cadaveric study demonstrated that the AAMP technique provided greater accuracy than the TT technique in creating anatomical femoral tunnels. 1, 20 The AAMP technique is an alternative to the above-mentioned techniques and offers the following advantages.…”

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confidence: 99%

Accessory Anteromedial Portal may not Provide Clinically Superior Results Compared with the Anteromedial Portal in Anterior Cruciate Ligament Reconstruction

Jing

et al. 2017

J Knee Surg

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Techniques using the anteromedial portal (AMP) and accessory anteromedial portal (AAMP) are commonly used in anterior cruciate ligament (ACL) reconstruction. The aim of this study was to investigate the radiological and clinical outcomes of arthroscopic single-bundle ACL reconstruction using the AMP or AAMP technique to drill the femoral tunnel. The records of 157 patients who underwent single-bundle ACL reconstruction using the AMP or AAMP technique between 2011 and 2015 were reviewed. The femoral tunnel clock-face position and femoral tunnel and tibial tunnel anterior-posterior (AP) inclination angles were assessed on axial or AP magnetic resonance images. At last follow-up, the Lachman test and pivot-shift test were used to evaluate AP and rotational stability, respectively. The Lysholm knee scoring scale and the International Knee Documentation Committee (IKDC) form were used to evaluate clinical and functional results. No statistically significant differences were found between the groups in patient age, sex, follow-up period, or affected side distribution. The mean femoral tunnel inclination angle was 31.13 ± 8.06 degrees in the AMP group and 30.17 ± 9.02 degrees in the AAMP group ( = 0.513). The tibial tunnel inclination angle in the AMP group (16.28 ± 7.89 degrees) was not different from that in the AAMP group (13.70 ± 6.08 degrees). No significant differences were observed between the two groups in the Lachman test, pivot-shift test, Lysholm knee scoring scale, or IKDC scores. The AAMP technique was not clinically superior to the AMP technique in ACL reconstruction. This is a retrospective comparative study and its level of evidence is III.

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Is there any clinical superiority of the anteromedial portal compared to the Transtibial in Anterior Cruciate Ligament reconstruction in non-professional athlete patients in short term follow-ups?

Abstract: The AM technique has no clinical superiority compared to the TT technique in ACL reconstruction in nonprofessional athletes.

Cited by 11 publications

References 26 publications

Anteromedial versus transtibial technique in single-bundle autologous hamstring ACL reconstruction: a meta-analysis of prospective randomized controlled trials

Anteromedial versus transtibial technique in single-bundle autologous hamstring ACL reconstruction: a meta-analysis of prospective randomized controlled trials

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Accessory Anteromedial Portal may not Provide Clinically Superior Results Compared with the Anteromedial Portal in Anterior Cruciate Ligament Reconstruction

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