Is there a difference between the flexible and rigid reamer in femoral tunnel length in ACL reconstruction in anteromedial portal

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction was functionally done on trans-tibial section and was creating vertical long tunnel. Nowadays, it is done by modified trans-tibial and anterior-medial portal which creates short tunnel compared to trans-tibial approach. Objective: To compare femoral tunnel length using a flexible versus rigid reamer in ACL antero-medial portal reconstruction surgery. Materials and Methods: Retrospective medical record analysis of all ACL reconstruction surgeries performed between February and December 2014 among 3 surgeons in security force hospital in Riyadh was done. In all of these procedures, the femoral tunnel length was measured with digital calipers from 20 to 48 mm and was reported in mm. Result: A total of 309 ACL reconstructions were done, 151 (18.9%) using a flexible reamer and 158 (51.1%) with a rigid reamer. The overall mean tunnel length was 38.6 ± 5.2 mm. The mean tunnel length in cases that used the flexible reamer was 39.0 ± 4.9 mm, and the mean tunnel length in cases that used the rigid reamer was 38.1 ± 5.4 mm. The mean difference in the tunnel length between flexible and rigid reamer was 0.88 mm. There was no statistical difference between the mean tunnel lengths between flexible and rigid reamers. There were no significant differences in the tunnel length performed by 3 different surgeons. Conclusion: The femoral tunnel lengths were not significantly different with the use of a flexible or a straight reamer.