Comparison of Clinical Results of Anteromedial and Transtibial Femoral Tunnel Drilling in ACL Reconstruction

Abstract Background: This study compares long term results of femoral tunnel drilling between anteromedial (AM) and transtibial (TT) techniques in reconstruction of anterior cruciate ligament (ACL). Methods: 300 patients with ACL reconstructions were chosen to this study from previously collected data of ACL reconstructions.They were divided into two groups: 150 patients with AM and 150 with TT drilling. In the AM group the reconstructions were performed using semitendinosus graft with Tape Locking Screw (TLS™) technique (n=87) or Retrobutton™ femoral and BioScrew™ tibial fixation with a semitendinosus-gracilis graft (n=63). In the TT group the fixation method used was Rigidfix™ femoral and Intrafix tibial fixation with a semitendinosus-gracilis graft. The evaluation methods were clinical examination, knee scores (Lysholm, Tegner, IKDC) and instrumented laxity measurements (KT-2000™). Our aim was to evaluate if there is a better rotational stability and therefore better clinical resultswhen using AM drilling compared to TT drilling. Results: Revision procedures were excluded from the study. There were 132 patients in the AM group and 133 in the TT group for evaluation. In the two year follow-up there were 60 patients in the AM group (45,5 %) and 58 in the TT group (43,6 %). There were no statistically significant differences found between the groups. Conclusion: Both drilling techniques resulted in improved patient performance and patient satisfaction. We found no data supporting the hypothesis that AM drilling technique provides better rotational stability to the knee. Trial registration: ISRCTN registry with study ID ISRCTN16407730. Keywords: Anterior cruciate ligament reconstruction; clinicaloutcome; anteromedial; transtibial