2015 ISAKOS Biennial Congress ePoster #1390

Comparison of Clinical Outcomes Between Transtibial and Anteromedial Portal Techniques for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Toshiyuki Iwame, MD, Tokushima JAPAN
Yoshitsugu Takeda, MD, PhD, Komatsushima, Tokushima JAPAN
Yoshiteru Kawasaki, MD, PhD, Komatsushima, Tokushima JAPAN
Kenichiro Kita, MD, Komatsushima, Tokushima JAPAN
Rui Amari, MD, Komatsushima, Tokushima JAPAN
Katsutoshi Miyatake, MD, PhD, Yoshinogawa, Tokushima JAPAN
Yasuaki Tamaki, MD, Komatsushima, Tokushima JAPAN
Takashi Nakayama, MD, PhD, Komatsushima, Tokushima JAPAN
Koji Fujii, MD, PhD, Komatsushima, Tokushima JAPAN
Tokushima Red Cross Hospital, Komatsushima, Tokushima, JAPAN

FDA Status Not Applicable

Summary: 108 patients who underwent anatomic double-bundle ACL reconstruction with hamstring tendons were divided into 2 groups based on the femoral tunnel drilling (Transtibial vs. Anteromedial portal), and the clinical outcomes at minimum 2-year follow-up including KT-2000, Lachman, pivot shift, IKDC form, Lysholm score, and Tegner activity scale were not significantly different between the 2 groups.

Abstract:

Purpose:In the double-bundle ACL reconstruction, several studies indicated that the anteromedial portal technique (AMP) for femoral tunnel drilling is more accurate than the transtibial technique (TT) in terms of femoral tunnel placement. However, whether the AMP technique results in better outcomes compared to the TT technique has not been well documented. The purpose of this study was to compare the clinical outcomes between TT and AMP techniques for anatomic double-bundle ACL reconstruction.
Methods:This study involved 108 patients who underwent anatomic double-bundle ACL reconstruction with hamstring tendons. The patients were divided into 2 groups based on the method used for creation of the femoral tunnel (TT: n=50, AMP: n=58). The same surgeon performed all the surgeries in the both groups, and the same postoperative rehabilitation program was applied. Clinical outcomes at minimum 2-year follow-up (range 24-39 months) were assessed by KT-2000 measurement, Lachman test, pivot shift test, International Knee Documentation Committee (IKDC) objective and subjective form, Lysholm score, and Tegner activity scale. Data was analyzed by unpaired t-test and Chi square test. A power calculation performed before the study indicated that 46 patients per group would be required.
Results:No differences in demographic characteristics were observed between the 2 groups. There was no significant difference in postoperative KT-2000 measurements between the 2 groups (1.5mm±2.0mm in TT and 1.7±2.1mm in AMP, P = .27). TT and AMP groups had similar results for Lachman test (90% vs. 93% with negative results), pivot shift test (83% vs. 81% with negative results), objective IKDC form (92% vs. 86% with normal or nearly normal), subjective IKDC score (92.0 vs. 93.9), Lysholm score (95.5 vs. 97.4), and Tegner activity scale (6.6 vs. 6.7).
Conclusion:TT and AMP techniques for anatomic double-bundle ACR reconstruction had comparable clinical outcomes at minimum 2-year follow-up.