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Outcome of arthroscopic single-bundle anterior cruciate ligament reconstruction: anteromedial portal technique versus transtibial drilling technique

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Abstract

Purpose

Controversies exist about the femoral tunnel preparation technique in anterior cruciate ligament (ACL) reconstruction surgeries. The aim of this study was to evaluate mid-term outcomes of transtibial (TT) technique in comparison with anteromedial portal (AMP) one.

Methods

Demographic data, height, weight, period of time from injury to surgery, and follow-up duration of patients underwent ACL reconstruction using single-bundle hamstring graft by the senior author between 2007 and 2011 were evaluated, retrospectively. Mid-quadriceps circumference difference, passive range of motion of the joint, anterior drawer test, Lachman test, and pivot shift test were assessed for each case. Function of the knee joint was calculated using International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores.

Results

Of 50 cases in the AMP group (age 30.6 ± 6.5), 45 were male and of the 44 patients in the TT group (age 30.0 ± 6.5), forty were male. Mean follow-up times in the AMP and TT group were 18.2 months (range 12–84 months) and 25.7 months (range 16–48 months), respectively. No statistically significant difference was found in mid-quadriceps circumference difference (P = 0.861). Also, functional knee scores (P values of IKDC = 0.329, Lysholm score = 0.08, Tegner = 0.504) and stability tests (P values of anterior drawer test = 0.07, Lachman test = 0.486, pivot shift test = 0.348) did not differ statistically between groups.

Conclusion

There is no superiority of AMP technique on TT technique in ACL reconstructive surgeries. It could be suggested that performing a well-done technique, either TT or AMP, may be more important than only choosing a technique.

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Acknowledgments

This article has been obtained from a thesis submitted to the Shiraz University of Medical Sciences (registered no. 91-01-01-4464) in partial fulfillment of the requirement for the degree of specialty in orthopedic surgery. The project is sponsored by Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences.

Funding

This project with number of 91-01-01-4464 in Vice-Chancellery of Research and Technology of Shiraz University of Medical Sciences is sponsored by Bone and Joint Diseases Research Center, as a thesis in partial fulfillment of the requirement for the degree of specialty in orthopedic surgery.

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Authors and Affiliations

  1. Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    S. Rezazadeh & A. R. Vosoughi

  2. International Branch of Shiraz University of Medical Sciences, Marvdasht, Iran

    H. Ettehadi

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  1. S. Rezazadeh
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  2. H. Ettehadi
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Correspondence to A. R. Vosoughi.

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Conflict of interest

To the best of our knowledge, no conflict of interest, financial or other, exists. Dr. Soorena Rezazadeh, Dr. Hossein Ettehadi, and Dr. Amir R Vosoughi declare that they had no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of Shiraz University of Medical Sciences and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Rezazadeh, S., Ettehadi, H. & Vosoughi, A.R. Outcome of arthroscopic single-bundle anterior cruciate ligament reconstruction: anteromedial portal technique versus transtibial drilling technique. Musculoskelet Surg 100, 37–41 (2016). https://doi.org/10.1007/s12306-015-0392-x

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