Transtibial Versus Independent Drilling Techniques for Anterior Cruciate Ligament Reconstruction

Riboh, Jonathan C.; Hasselblad, Vic; Godin, Jonathan A.; Mather, Richard C.

doi:10.1177/0363546513506979

Cited by 124 publications

(111 citation statements)

References 79 publications

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“…This finding is consistent with previous studies for the transtibial group [2,5], but not for independently drilled tunnels. However, at short-term followup, the study groups were comparable in terms of knee stability and patient-reported outcomes.…”

supporting

confidence: 93%

See 1 more Smart Citation

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

2016

Clinical Orthopaedics &Amp; Related Research

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supporting

confidence: 93%

“…Two recently published meta-analyses [2,5] showed that ACL reconstruction with independently-drilled tunnels results in more anatomic femoral and tibial bone tunnels. In particular, the femoral posterolateral bundle of the ACL is missed with the transtibial technique.…”

mentioning

confidence: 99%

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

2016

Clinical Orthopaedics &Amp; Related Research

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“…A broadly discussed topic in current ACL research is graft placement [36], which has straight correlation with knee rotational stability although it was not considered in the trials of our review. Furthermore, reports showing residual instability after ACL reconstruction mostly are outdated, and consequently an old-fashioned vertical tunnel might be the origin of this high rate of reported rotational instability [6,21,37].…”

Section: Discussionmentioning

confidence: 99%

Does Combined Intra- and Extraarticular ACL Reconstruction Improve Function and Stability? A Meta-analysis

Rezende

Moraes

Martimbianco

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background ACL reconstruction aims to restore knee function and stability; however, rotational stability may not be completely restored by use of standard intraarticular reconstruction alone. Although individual studies have not shown the superiority of combined ACL reconstruction compared with isolated intraarticular reconstruction in terms of function and stability, biomechanical principles suggest a combined approach may be helpful, therefore pooling (meta-analyzing) the available randomized clinical studies may be enlightening. Questions/purposes We performed a meta-analysis to determine whether combining extraarticular with intraarticular ACL reconstruction would lead to: (1) similar knee function measured by the IKDC evaluation, return-toactivity, and Tegner Lysholm scores, compared with isolated intraarticular reconstruction; (2) increased stability measured by pivot shift and instrumented Lachman examination; and (3) any differences in complications and adverse events? Methods To identify randomized controlled trials (RCTs) comparing combined intra-and extrarticular ACL reconstruction (combined reconstruction) with intraarticular ACL reconstruction only, we searched MEDLINE, EMBASE, SPORTDiscus, Latin American and Caribbean Health Sciences (LILACS), and the Cochrane Central Register of Controlled Trials, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The main outcomes we sought were patient function and stability and complications after ACL reconstruction. Of 386 identified studies, eight RCTs were included (n = 682 participants; followup, 12-84 months; men to women ratio, 2.17:1) in our meta-analysis. Study quality (internal validity) was assessed using the Cochrane risk-of-bias tool; in general, we found a moderate quality of evidence of the included studies. Results When functional outcomes were compared, we found no difference between patients who underwent intraarticular ACL reconstruction only and those who underwent combined reconstruction (IKDC, return-to-activity, and Tegner Lysholm scores). However, patients who underwent combined reconstruction were more likely to show improved stability based on the pivot shift test (risk ratio [RR], 0.95; 95% CI, 0.91-0.99; p = 0.02) and Lachman test (RR, 0.93; 95% CI, 0.88-0.98; p = 0.01). In addition, our meta-analysis found no difference between the two treatments in terms of general complications or adverse events (RR, 1.31; 95% CI, 0.70-2.34; p = 0.40) and the proportion of patients whose reconstructions failed (RR, 2.88; 95% CI, 0.73-11.47; p = 0.13).

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“…Foster et al, 9 in their review of level 1 and 2 studies, calculated graft failure rates of 4.7% and 8.2% for autograft and allograft tissues, respectively. 13,15,17,18,22,29,30 They…”

Section: Discussionmentioning

confidence: 99%

Thirty-year Experience with ACL reconstruction using Patellar Tendon: A Critical Evaluation of Revision and Reoperation

Riff¹,

Luchetti²,

Weber³

et al. 2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Transtibial Versus Independent Drilling Techniques for Anterior Cruciate Ligament Reconstruction

Cited by 124 publications

References 79 publications

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Does Combined Intra- and Extraarticular ACL Reconstruction Improve Function and Stability? A Meta-analysis

Thirty-year Experience with ACL reconstruction using Patellar Tendon: A Critical Evaluation of Revision and Reoperation

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