Abstract
Abstract Introduction: Although the results of anterior cruciate ligament (ACL) reconstruction are well documented in many studies, with good to excellent outcomes in most cases, some issues like tunnel positioning are still discussed and studied. Objective: To compare the objective and subjective clinical outcomes of ACL reconstruction using the transtibial and anteromedial portal techniques. Methods: Prospective randomized study of 80 patients undergoing anterior cruciate ligament reconstruction by the same surgeon, with 40 patients operated by the transtibial technique and 40 by anteromedial portal technique. The patients, 34 in the transtibial group and 37 in the anteromedial portal group (nine dropouts), were reassessed during a 2-year follow-up period. The clinical assessment consisted of physical examination, KT-1000TM evaluation, Lysholm score, and objective and subjective International Knee Documentation Committee - IKDC scores. Results: Regarding the Lachman and pivot shift tests, we observed more cases of instability in the transtibial group, but with no statistical significance (p=0.300 and p=0.634, respectively). Regarding the anterior drawer test, the groups presented similar results (p=0.977). Regarding KT-1000TM evaluation, the mean results were 1.44 for the transtibial group and 1.23 for the anteromedial portal group, with no statistical significance (p=0.548). We separated the objective IKDC scores into two groups: Group 1, IKDC A, and Group 2, IKDC B, C, or D, with no statistical significance (p=0.208). Concerning the Lysholm score, the transtibial group had a mean score of 91.32, and the anteromedial portal group had a mean score of 92.81. The mean subjective IKDC scores were 90.65 for the transtibial group and 92.65 for the anteromedial portal group. Three re-ruptures were encountered in the transtibial group and three in the anteromedial portal group. Conclusions: There were no significant differences in the subjective and objective clinical assessments among patients submitted to anterior cruciate ligament reconstruction using the transtibial or anteromedial portal techniques.
Highlights
The results of anterior cruciate ligament (ACL) reconstruction are well documented in many studies, with good to excellent outcomes in most cases, some issues like tunnel positioning are still discussed and studied
Anatomical studies have shown that tunnel positioning using this technique, the tibial tunnel dictates the femoral tunnel, and the result is a graft not centered at the ACL origin[2,4]
The objective assessment 2 years after surgery consisted of a physical examination, arthrometry using a KT1000TM arthrometer, and objective International Knee Documentation Committee (IKDC) score (IKDCo) evaluation
Summary
The results of anterior cruciate ligament (ACL) reconstruction are well documented in many studies, with good to excellent outcomes in most cases, some issues like tunnel positioning are still discussed and studied. Objective: To compare the objective and subjective clinical outcomes of ACL reconstruction using the transtibial and anteromedial portal techniques. Conclusions: There were no significant differences in the subjective and objective clinical assessments among patients submitted to anterior cruciate ligament reconstruction using the transtibial or anteromedial portal techniques. Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed surgeries in Orthopedics The results of this procedure are well documented in many studies, with good to excellent outcomes in most cases, but some issues regarding fixation methods[1] and tunnel positioning are still discussed and studied[2]. Biomechanical[2,5] and clinical[6,7] studies have shown advantages regarding the stability acquired with a more anatomical positioning of the femoral tunnel compared with the transtibial technique, but there is not a consensus regarding long term clinical results and rerupture[8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
