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Anatomic single-bundle anterior cruciate ligament reconstruction using the outside-in femoral tunnel drilling technique: a prospective study and short- to mid-term results

Archives of Orthopaedic and Trauma Surgery volume 135, pages 383–392 (2015)Cite this article

Abstract

Introduction

Anatomic positioning of the femoral and tibial tunnels in the native ACL femoral and tibial footprints requires an independent drilling either via an accessory medial portal (trans-portal drilling) or using an outside-in drilling technique. Conventional trans-tibial drilling (dependant drilling) was found to lack the ability to accurately position the femoral tunnel in the native ACL footprint. The purpose of the current study was to evaluate the functional outcome results of anatomic single-bundle ACLR using the OI femoral tunnel drilling technique.

Materials and methods

Single surgeon single center prospective case series study. 64 patients having complete ACL tears were included in the current study. Average follow-up was 15.8 months (range 8–25). Objective and subjective IKDC scores, Lysholm knee score, SF-36 score, VAS for patients’ satisfaction, VAS for pain and Kellgren and Lawrence (K/L) classification of osteoarthritis were used for follow-up evaluation.

Results

Objective IKDC score revealed that 60 patients had grade ‘‘A’’ and 4 had grade ‘‘B’’, while no single patient had neither grade ‘‘C’’ nor ‘‘D’’. The average Lysholm Score was 92.4, average subjective IKDC was 91.5. Average SF-36 score was 96.7. The average VAS for operation satisfaction was 9.7. Average VAS for pain was 0.3. Forty-nine patients were classified as normal K/L classification, 7 were grade ‘‘1’’, 8 were grade ‘‘2’’. Comparing pre-operative and follow-up Objective IKDC, Subjective IKDC, Lysholm, SF-36 and VAS for pain scores revealed statistically significant differences (P value <0.05).

Conclusion

Arthroscopic-assisted ACL reconstruction using the outside-in femoral tunnel drilling technique shows a good and satisfactory functional outcome results at short- to mid-term follow-up.

Level of evidence

Level IV.

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Acknowledgment

Authors certify that their institution has approved the conduction of and their participation in this study, and that all investigations were conducted in conformity with ethical principles of research, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

None.

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Affiliations

  1. Orthopaedic Surgery and Traumatology Department, Faculty of Medicine, Suez Canal University, Circular Road, Ismailia, 41522, Egypt

    Ashraf Abdelkafy

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  1. Ashraf Abdelkafy
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Correspondence to Ashraf Abdelkafy.

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Abdelkafy, A. Anatomic single-bundle anterior cruciate ligament reconstruction using the outside-in femoral tunnel drilling technique: a prospective study and short- to mid-term results. Arch Orthop Trauma Surg 135, 383–392 (2015). https://doi.org/10.1007/s00402-015-2160-7

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  • DOI: https://doi.org/10.1007/s00402-015-2160-7

Keywords

  • Anatomic ACL reconstruction
  • Outside-In
  • Femoral tunnel
  • Follow-up evaluation
  • Prospective study
  • Short- to mid-term