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Clinical comparisons between the transtibial technique and the far anteromedial portal technique for posterolateral femoral tunnel drilling in anatomic double-bundle anterior cruciate ligament reconstruction.
Arthroscopy. 2012 May; 28(5):658-66.A

Abstract

PURPOSE

The purpose of this study was to compare the clinical results of the transtibial and far anteromedial portal techniques for posterolateral (PL) femoral tunnel drilling in double-bundle anterior cruciate ligament reconstruction.

METHODS

This study involved 50 patients who underwent double-bundle anterior cruciate ligament reconstruction and were followed up for more than 2 years. The anteromedial bundle was reconstructed with the far anteromedial portal technique in all patients. However, the PL bundle was reconstructed with the transtibial and far anteromedial portal techniques in 22 patients (group T) and 28 patients (group F), respectively. The follow-up visits included evaluation of Lysholm knee scores, KT-2000 measurement of anterior knee laxity (MEDmetric, San Diego, CA), the pivot-shift test, and radiography.

RESULTS

The length of the PL femoral tunnel in group F (32.2 mm) was significantly shorter than that in group T (39.0 mm). Lateral knee radiographs showed that the positions of the EndoButtons (Smith & Nephew Endoscopy, Andover, MA) for the PL bundles were significantly more posterior (12.8 mm) and distal (3.1 mm) in group F than in group T. The mean KT-2000 side-to-side difference in group T (0.9 mm) and group F (0.7 mm) did not significantly differ. In addition, no significant difference was noted between the groups with respect to Lysholm knee scores and the pivot-shift test results.

CONCLUSIONS

This study showed that the far anteromedial portal technique is as effective as the transtibial technique and results in good restoration of joint stability and knee scores despite shorter femoral tunnel length and inferoposterior position of the EndoButton.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. nakamae@hiroshima-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

22284409

Citation

Nakamae, Atsuo, et al. "Clinical Comparisons Between the Transtibial Technique and the Far Anteromedial Portal Technique for Posterolateral Femoral Tunnel Drilling in Anatomic Double-bundle Anterior Cruciate Ligament Reconstruction." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 28, no. 5, 2012, pp. 658-66.
Nakamae A, Ochi M, Adachi N, et al. Clinical comparisons between the transtibial technique and the far anteromedial portal technique for posterolateral femoral tunnel drilling in anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2012;28(5):658-66.
Nakamae, A., Ochi, M., Adachi, N., Deie, M., & Nakasa, T. (2012). Clinical comparisons between the transtibial technique and the far anteromedial portal technique for posterolateral femoral tunnel drilling in anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 28(5), 658-66. https://doi.org/10.1016/j.arthro.2011.10.025
Nakamae A, et al. Clinical Comparisons Between the Transtibial Technique and the Far Anteromedial Portal Technique for Posterolateral Femoral Tunnel Drilling in Anatomic Double-bundle Anterior Cruciate Ligament Reconstruction. Arthroscopy. 2012;28(5):658-66. PubMed PMID: 22284409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical comparisons between the transtibial technique and the far anteromedial portal technique for posterolateral femoral tunnel drilling in anatomic double-bundle anterior cruciate ligament reconstruction. AU - Nakamae,Atsuo, AU - Ochi,Mitsuo, AU - Adachi,Nobuo, AU - Deie,Masataka, AU - Nakasa,Tomoyuki, Y1 - 2012/01/28/ PY - 2010/10/23/received PY - 2011/08/23/revised PY - 2011/10/23/accepted PY - 2012/1/31/entrez PY - 2012/1/31/pubmed PY - 2012/8/23/medline SP - 658 EP - 66 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 28 IS - 5 N2 - PURPOSE: The purpose of this study was to compare the clinical results of the transtibial and far anteromedial portal techniques for posterolateral (PL) femoral tunnel drilling in double-bundle anterior cruciate ligament reconstruction. METHODS: This study involved 50 patients who underwent double-bundle anterior cruciate ligament reconstruction and were followed up for more than 2 years. The anteromedial bundle was reconstructed with the far anteromedial portal technique in all patients. However, the PL bundle was reconstructed with the transtibial and far anteromedial portal techniques in 22 patients (group T) and 28 patients (group F), respectively. The follow-up visits included evaluation of Lysholm knee scores, KT-2000 measurement of anterior knee laxity (MEDmetric, San Diego, CA), the pivot-shift test, and radiography. RESULTS: The length of the PL femoral tunnel in group F (32.2 mm) was significantly shorter than that in group T (39.0 mm). Lateral knee radiographs showed that the positions of the EndoButtons (Smith & Nephew Endoscopy, Andover, MA) for the PL bundles were significantly more posterior (12.8 mm) and distal (3.1 mm) in group F than in group T. The mean KT-2000 side-to-side difference in group T (0.9 mm) and group F (0.7 mm) did not significantly differ. In addition, no significant difference was noted between the groups with respect to Lysholm knee scores and the pivot-shift test results. CONCLUSIONS: This study showed that the far anteromedial portal technique is as effective as the transtibial technique and results in good restoration of joint stability and knee scores despite shorter femoral tunnel length and inferoposterior position of the EndoButton. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/22284409/Clinical_comparisons_between_the_transtibial_technique_and_the_far_anteromedial_portal_technique_for_posterolateral_femoral_tunnel_drilling_in_anatomic_double_bundle_anterior_cruciate_ligament_reconstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(11)01261-8 DB - PRIME DP - Unbound Medicine ER -