2017 ISAKOS Biennial Congress ePoster #1143
Comparison Of Clinical Results, Second-Look Arthroscopic Findings And Magnetic Resonance Imaging Findings After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using Transportal And Outside-In Techniques – Minimum 2-Years Follow-Up Of Pro
Jae Gyoon Kim, MD, PhD, Prof., Ansan, Gyeonggi KOREA, REPUBLIC OF
Jin-Hwan Ahn, MD, Seoul KOREA, REPUBLIC OF
Jihoon Bae, MD, PhD, Seoul KOREA, REPUBLIC OF
Seung-Hoon Kang, MD, Changwon-Si, Gyeongsangnam-do KOREA, REPUBLIC OF
Joon Ho Wang, MD, PhD, Seoul KOREA, REPUBLIC OF
Korea University Ansan Hospital, Samsung Medical Center, Ansan-si, Seoul, Gyeonggi-do, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
There were no significant differences in clinical results, second-look arthroscopic findings, and postoperative MRI findings between transportal and outside-in technique after anatomic double-bundle ACL reconstruction at short term follow-up (minimum 2 years).
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Abstract
Purpose
The purpose of our prospective randomized controlled trial was to compare clinical results, second-look arthroscopic findings, and magnetic resonance imaging (MRI) findings after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction using transportal (TP) and outside-in (OI) technique.
Methods
From February 2011 to March 2013, 120 patients were included and were randomly assigned to either the TP group (n = 60) or OI group (n = 60) on the day of surgery using permuted block randomization. All patient underwent double-bundle ACL reconstruction using either TP or OI technique. All operative procedures were performed by a single surgeon who had experience in ACL reconstruction using both techniques. Institutional review board approval was obtained from our institution before proceeding with this study. Total 111 patients (92.5%, TP: n=53, OI: n=58) were followed-up (minimum 2 years after operation), and they were clinically evaluated concerning the side to-side anterior laxity, the pivot-shift test, the Lachman test, the Lysholm knee score, the HSS score, the Tegner score, and the International Knee Documentation Committee (IKDC) subjective and objective score. Of the 120 patients, 93 (77.5%) consented to undergo second look arthroscopic examination between 1 and 2 years for screw removal. The graft tension, continuity and synovialization were evaluated. We took the postoperative MRI of 78 knees (65%) between 5 and 7 months after surgery, and we also evaluated graft continuity, femoral graft tunnel healing, and the signal/noise quotient (SNQ) to quantify the normalized signal intensity of the ACL graft using OsiriX imaging software.
Results
The mean follow-up period was 32.0 ± 12.8months (24-60 months). There were no significant differences in patient demographics, Lachman test, pivot shift test, and all clinical scores between the 2 groups (P>0.05) except objective IKDC score (P=0.03). The postoperative side-to-side anterior laxity averaged 1.7mm (20lb), 2.1mm (30lb and manual maximum test), showing no statistical difference between two groups (P>0.05). There were also no signi?cant differences between the two groups concerning second look arthroscopic findings (P>0.05). The postoperative MRI findings also showed no significant differences between two groups (P>0.05).
Conclusion
The clinical results except IKDC objective score, second-look arthroscopic findings, and MRI findings of OI technique for anatomic ACL reconstruction were not different from TP technique at short term minimum 2-years follow-up, although there were significant differences of femoral tunnel geometries between two techniques.