Comparison of femoral tunnels between transtibial tunnel and anteromedial portal drillings in anterior cruciate ligament reconstruction

Abstract

ObjectiveTo compare lengths and angles of the femoral tunnels which are drilled by transtibial technique and through the anteromedial portal in arthroscopic anterior cruciate ligament (ACL) reconstruction.MethodsFrom November 2000 to November 2009, 102 patients underwent ACL reconstruction. Their femoral tunnels were drilled by transtibial technique in 50 patients (39 men and 11 women with an average age of 27.9 ±7. 6 years) and through anteromedial arthroscopic portal in 52 (33 men and 19 women with an average age of 30. 5 ± 10. 7 years) . The femoral tunnel lengths were recorded during surgery and tunnel angles on coronal and sagittal planes were measured on postoperative X-ray films for statistical analysis (student t test with a significant level of 0. 05 ).ResultsThe mean length of femoral tunnel by transtibial technique (50. 9 ± 5.0 mm) was significantly larger than that through anteromedial portal (37.8 ± 4. 7 mm) ( t =15. 083, P =0. 000). The mean angles of femoral tunnel by transtibial technique on coronal plane (68. 6°± 7.0°) and on sagittal plane (45. 1°± 8.1°) were significantly larger than those through anteromedial portal on coronal plane (49. 8° ± 7.7°) and on sagittal plane (33.7° ± 9. 7°) ( t =12. 874, P =0. 000; t =5. 877, P =O. 000) .ConclusionBecause the femoral tunnel drilled through anteromedial portal is significantly shorter in length and smaller in angles, it can lead to potentially better clinical outcomes in arthroscopic ACL reconstruction. Key words: Anterior cruciate ligament; Arthroscopy; Bone tunnel