Arthroscopic reconstruction of anterior cruciate ligament with femoral tunnel made by three-portal technique

Abstract

Objective To evaluate the clinical outcomes of arthroscopic reconstruction of anterior cruciate ligament (ACL) with femoral tunnel made by three-portal technique. Methods From February 2014 to May 2015, fifty-five ACL rupture patients (38 males and 17 females) with mean age 31.46±7.34 (range, 16 to 48) who underwent single-bundle ACL reconstruction with femoral tunnel made by three-portal technique by the same surgeon were followed up. The average preoperative duration was 15.39±18.57 (range, 5 to 180) days. All patients presented the positive Lachman test, of which 32 patients had 1 grade pivot-shift test, 15 patients 2 grade and 8 patients 3 grade. At final follow-up, the International Knee Documentation Committee (IKDC) and Lysholm scores were used to estimate knee joint function, while the Lachman test and pivot-shift test were used to estimate knee joint stability. Results All patients were followed up for 26.73±5.23 (range, 21 to 34) months. The femoral tunnel positions were accurate without fracture of the back walls in all patients. The mean length of femoral tunnel was 38.58±3.76 (range, 35 to 42) mm, and the mean angles of femoral tunnel on coronal plane was 49.32°±2.45° (range, 45° to 52°). All patients presented negative Lachman test. Fifty-one patients presented negative pivot-shift test, while the remaining 4 patients had 1 grade of the rotational laxity. Forty-nine patients showed normal range of motion, while two had 5° flexion deficit, one had less than 5° flexion deficit and three had 5° hyper-extension loss. Furthermore, the IKDC score significantly was improved from 73.31±5.83 preoperatively to 94.63±3.16 at the latest follow-up (t=10.14, P<0.001). The Lysholm score significantly was increased from 66.35±8.91 preoperatively to 95.32±4.25 at final follow up (t=12.76, P<0.001). Conclusion Arthroscopic reconstruction of ACL with femoral tunnel made by three-portal technique is an reliable technique with the advantage of simple procedure and accurate femoral tunnel position in surgery. Key words: Knee Joint; Anterior cruciate ligament reconstruction; Arthroscopy