A comparative study between transtibial and anatomical arthroscopic anterior cruciate ligament reconstruction of knee

Abstract

Introduction: Knee injuries are very common due to sports and repetitious activities. Of these ACL injuries are the most common. Surgical treatment with ACL reconstruction has now become gold standard in management of ACL injury. The main aim in anterior cruciate ligament surgery is to reproduce the normal kinematics of the knee and provide stability in the sagittal and coronal plane. There is better patient satisfaction associated with better stability and kinematics. The objective of our study is to compare the results of outcome following ACL reconstruction using the transtibial and the anatomical technique or femoral tunnel placement. Results: Out of 50 cases 38 were males 12 were females. Right knee was commonly involved compared to left accounting for 52% cases. Young patients between 17 and 35 years constituted the maximum number who suffered from ACL injuries. 60% of cases were due to motor vehicular accidents (MVA). Post injury there was an average fall of 50% in activity levels as compared to pre injury levels in both the groups. The patients in anatomical group attained 86.36% of pre injury activity level on an average, while those in transtibial group achieved 63.87%, a difference of 25.56%. There was a difference of a significant 19.40% in both group Lysholm Tegner Knee score with anatomical group having 90.92% and transtibial having 73.28% of score. Interpretation and conclusion: The anatomical ACL reconstruction group performed better in subjective outcome of Lysholm Tegner Knee Score as well as in achieving greater percentage of pre injury activity level as compared to the transtibial group of ACL reconstruction. Hence anatomical placement of femoral tunnel using anteromedial accessory portal is a better surgical option when compared to transtibial femoral tunnel placement in ACL reconstruction surgeries to achieve a more near normal knee kinematics.