Anterior cruciate ligament reconstruction : antero-medial portal vs trans-tibial femoral tunnel drilling

Abstract

Introduction: The anterior cruciate ligament (ACL) is an important part of the function of the knee joint. Rupture is common in sporting activities and can preclude athletes from pursuing their sport. A more anatomical technique of drilling of the femoral tunnel in repair of this ligament is thought to yield better functional outcomes than non-anatomical techniques.

Aim: The aim of this study is to compare functional outcomes of single bundle, bone - patellar tendon - bone, ACL repair using a trans-tibial approach versus an anteromedial portal to drilling of the femoral tunnel.

Method: A total of 43 patients having had surgery were recruited. Each of these patients were operated using an anteromedial approach to femoral tunnel drilling. IKDC (International Knee Documentation Committee) scores were implemented and each patient was asked whether or not they returned to sporting activities after surgery. The results were compared to those from previous patients having undergone surgery with femoral tunnel drilling through a trans-tibial approach instead.

Results: IKDC scores appear to be significantly better when an anteromedial approach is implemented. Average and below average results were significantly decreased and the rate of return to sport was improved compared to results with a trans-tibial approach to femoral tunnel drilling.

Conclusion: In conclusion, results from an anteromedial portal approach to femoral tunnel drilling were superior to a trans-tibial approach. Functional outcomes appear to be improved and so we recommend that an anteromedial approach be preferred over a trans-tibial approach.