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Farmedial versus anteromedial portal drilling of the femoral tunnel in ACL reconstruction: a computed tomography analysis

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The success of ACL reconstruction is predicated on a variety of factors. Tunnel placement plays one of the most significant roles in achieving knee kinematics and function. The purposes of this study were to compare femoral tunnel position, angle, length and posterior wall blow-out after ACL reconstruction with hamstring tendons autograft through either a farmedial portal or an anteromedial portal technique.

Materials and methods

We evaluated 36 patients who underwent ACL reconstruction between January 2014 and July 2014 in our institute, in a prospective, randomised cohort study. All the surgical procedures were performed by a sports fellowship-trained orthopaedic surgeon with experience in both portal reaming. The operated knees were evaluated with 0.5 mm fine CT scans of 3-D CT between days 3 and 5 postoperatively.

Results

According to the 3-D CT measurements, the mean femoral tunnel length was significantly longer (p < 0.05) in the FAM group compared with the AM group. The femoral bone tunnel length averaged 34.2 ± 3.6 mm versus 36.6 ± 3.0 mm (p = 0.042) in AM and the FAM groups, respectively. The femoral tunnel position, as evaluated with use of the quadrant method, was more anterior in the FAM transportal technique group, and the difference between the two groups was significant (p < 0.05).

Conclusion

FAM tranportal drilling of the femoral tunnel creates longer and anterior femoral tunnels with regard to the AM portal drilling techniques. Additional studies with clinical outcomes are required for the clinical relevance of these techniques and to show which one is superior.

Level of evidence

Level I, prospective randomised comparative cohort study.

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Acknowledgments

The authors thank Nihal Altintepe for her assistance with the statistical analysis.

Conflict of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. No funds were received in support of this study.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Department, Faculty of Medicine, Sakarya University, Sakarya, Turkey

    Mehmet Erdem

  2. Lütfi Kırdar Kartal Training and Research Hospital, Semsi Denizer Cad. E5. Yanyol Cevizli Kavsagı Kartal, İstanbul, 34890, Turkey

    Deniz Gulabi

  3. Radiology Department, Faculty of Medicine, Sakarya University, Sakarya, Turkey

    Kiyasettin Asil

  4. Orthopaedic and Traumatology Department, Bezmialem University, Fatih, İstanbul, 34093, Turkey

    Ahmet Can Erdem

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  1. Mehmet Erdem
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Correspondence to Deniz Gulabi.

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Erdem, M., Gulabi, D., Asil, K. et al. Farmedial versus anteromedial portal drilling of the femoral tunnel in ACL reconstruction: a computed tomography analysis. Arch Orthop Trauma Surg 135, 539–547 (2015). https://doi.org/10.1007/s00402-015-2176-z

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